Posted by Melissa Maimann on Oct 31, 2009 in
Birth,
Caesarean,
Home birth,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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The latest maternity figures released yesterday for England are very concerning. Reduced spontaneous deliveries, increased medical interventions and high caesarean section rates mean that women are not getting the type of birth they want and many are not getting the safest birth.
There’s a 4% increase in the number of births in consultant wards and a decrease in birth in NHS midwifery facilities. This is exactly the opposite direction to that intended in the government policy, Maternity Matters, which includes the government’s promise to allow women in England to choose where they give birth.
… Large numbers of women do not have a realistic possibility of choosing between a birth centre run by midwives, a consultant unit or a home birth.
If women did have choice, we would be expecting to see a falling caesarean section rate, far fewer women choosing obstetric units, a network of birth centres being used by 20-40% of women and a home birth rate approaching 30%. When healthy women can choose care at home or in a unit run by midwives, they are more likely to have straightforward births that are a safe and positive experience.
… England’s caesarean section rate is at 24.6%, well beyond the World Health Organisation’s recommendation of 10-15%. Obstetric units are there for women and babies with medical problems. It is quite wrong to fill them with healthy women who, given the option, would not choose them …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Caesarean, continuity of care, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery services, Normal Birth, Public and private hospitals, women's rights
Posted by Melissa Maimann on Oct 30, 2009 in
Midwifery Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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WOMEN giving birth at the Murwillumbah hospital will soon be safer, even if they are transferred to Tweed Heads in labour, a midwifery expert has said.
Southern Cross University associate professor of midwifery Heather Hancock said the Murwillumbah District Hospital will implement their new midwife-led birthing model in December.
“Those small community hospitals are moving to 21st century models of practice that involve continuity with mother and midwife,” Prof Hancock said.
… The Murwillumbah hospital … transfers high-risk maternity cases to Tweed Heads.
… But … this new model of practice will ensure more safety for mothers and their babies.
“It means the woman will have the same midwife during pregnancy, birth and afterwards care,” she said.
“If a woman was in continuity care the midwife would go with her (in the ambulance to Tweed Heads).
… “… in terms of safety it’s extremely important.”
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: continuity of care, hospital birth, midwife, Midwifery services
Posted by Melissa Maimann on Oct 29, 2009 in
Midwifery Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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Health minister Nicola Roxon has hinted that her landmark reforms to extend the roles of … midwives may be defeated …
… she called on the opposition not to vote against the legislation … She said opposition health spokesman Peter Dutton appeared to be against the legislation, which will see … midwives given access to MBS and PBS …
… Ms Roxon accused the opposition of siding with the medical profession … reforms had widespread community support.
“I expect the Opposition to stop pandering to special interest groups, vote for this important legislation and demonstrate they are prepared to back our moves to implement long overdue reforms that support the growing role of … midwives … “
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: hospital birth, Maternity Services Review, midwife, Midwifery, Midwifery services
Posted by Melissa Maimann on Oct 28, 2009 in
Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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More than 95 per cent of women in the UK are not able to choose where to give birth …
The National Childbirth Trust (NCT) … claims that some 95.8 per cent of women do not yet have access to a real choice between the three options of home birth with a midwife, a local midwifery facility or birth centre and an obstetric unit in a hospital.
These are the three choices defined in the 2007 Government report Maternity Matters, which guaranteed that women in England would have choice of place of birth by 2009.
Sarah Banks … who is mother to a 10-month-old girl, said she was given no choice when it came to childbirth … ‘The first thing the midwife asked me was ‘which hospital do you want to go to?’
‘There was no discussion about other options and no mention of the birth centre nearby.
‘I told her that I wanted to have my baby at home and she refused to discuss it as she said it was too early and wouldn’t be advisable as it was my first baby.’
… “across the UK, Government policies support women with this choice. However, in reality this is not even close to being delivered yet.
‘We want the governments to act now … ‘We know there are some financial policy obstacles hindering the achievement of choice the NHS could make much faster progress if it corrected these.
NCT believes that … women who are given the choice have an increased likelihood of straightforward births, while for the maternity services, increased choice is likely to lead to reduced costs, as currently most women give birth in an obstetric unit in a hospital, which is an expensive option …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Home birth, hospital birth, midwife, Midwifery, Midwifery services, women's rights
Posted by Melissa Maimann on Oct 27, 2009 in
Normal Birth This wonderful article is written by Julie Clarke. Julie is a highly esteemed childbirth educator and calmbirth® practitioner in Sydney. I am confident that all couples will benefit from the dynamic and sensitive way in which she teaches her classes.
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For some couples the transition into parenthood is filled with wonderful, exciting memories, and for others filled with anxiety and stress. Most men and women will experience a mix of emotions as they move through the series of changes which is the rite of passage to parenthood – pre-conception, pregnancy, labour, birth and the newborn period.
The wisest advice I can give for couples contemplating the journey to parenthood is to (with an open mind) read everything, ask millions of questions, listen to as many friends stories as possible, and then finally make decisions based on your intuition as to what seems right for you and your set of circumstances.
There is no doubt having a first baby is one of the most significantly life changing event in any person’s life, so it’s worth spending time mulling over some of the important concepts beforehand, such as who will you select to help support you through this process? It’s really important to gather a good support network to assist you, such as: family and friends, a general practitioner, a private midwife, public or private hospital, selecting between delivery suite or the birth centre, a naturopath, a chiropractor, a childbirth and parenting educator, the local breastfeeding association, just to name a few.
Many couples find the experience of pregnancy more than they expected both in terms of adjustment and the feeling of thrill, excitement, anticipation and wonder.
The current generation of expecting parent’s often describe themselves as ‘pioneers’ in comparison to the previous generation, as they have so many new and wonderful options the previous generation may not have been able to select. An example of this is the option of having their partner not only being present at the birth, but also very involved and supportive both physically and emotionally. Many men currently expecting their first child when asked, “Was your father at your birth?” reply emphatically “No!”, and for the rare one who says “Yes!” they usually haven’t had much of a description from their father as to what occurred – you could say for previous generation’s it’s all a bit of a blank.
Most grown men these days have been taught by their fathers how to mow the lawn, how to change a tyre on the car, how to BBQ steak and sausages, but can’t confidently turn to their Dad and ask expectantly, “Dad how do you support a woman during labour?” it’s a question that might possibly turn up a blank perhaps?
However, for the next generation it will be completely different, the vast majority of dads-to-be will be able to say “Ah well you’re asking me something that takes me back to one of the most incredible days of your mum’s and my life…on the day you were born and, by the way, because you were our first it was a bit of a long day and night actually, we spent hours in the shower with me rubbing your mum’s back for comfort, and then she decided to rest her legs as they were getting tired, so she laid in the bath under the midwife’s instruction and then next thing she pushed you out in the bath, it was the most incredible thing I’ve ever seen in my life, truly it was like witnessing a miracle! And then all of a sudden I remembered from our birth classes that if I wanted to receive the baby, and be the first person to hold you, to mention it to the midwife, which I did, and so she guided me easily into how to receive you. It was amazing I have never felt anything so soft and vulnerable in my life! I’ll never forget it, I looked up at your mum and she had tears in her beautiful eyes, and she was crying and I passed you up to her arms and she held you gently and quietly talked to you and cuddled you for a long time. Son, I hope you have an experience as wonderful as that when you meet your first child for the first time. It’s a memory your mother and I cherish together, and always will.”
I frequently hear from the dads-to-be attending my courses that, “I just don’t want to be useless to my partner during the labour and the birth, but I don’t know what to do?” I respond with many ideas and suggestions throughout the course, and I always recommend to couples pluck and choose what suits them best, as there are a wonderful variety of choices available to be able to create your own positive and memorable birth experience.
Underpinning all of my work in my classes is the philosophy of calmbirth® training, and that is encouraging, supporting and guiding family bonding between a couple as they prepare for the birth of their baby. To focus on the role and the value of each parent, the importance of mothers, and equally the importance of fathers in the life of their unborn and newborn baby. With this in mind, by encouraging enjoyment rather than stress and fear during the period of the pregnancy and birth, creates the space for a more conducive atmosphere for good solid family bonding. Relaxation, joy, hope, courage, determination, togetherness creates good strong loving relationships. In a nutshell that’s what it’s all about.
My Transition into Parenthood course covers birth and baby care aspects in a very practical way whilst the calmbirth® course guides the “thinking and feeling” preparation, and focuses on the important skills for labour. Plenty of couples prefer to do both courses for a well rounded sense of readiness.
Whatever steps you take towards childbirth, look for the things that both inform and nurture both of you in your transition to parenthood. It’s my passion and something I know creates the best outcomes for new parents.
Julie Clarke is a Childbirth and Parenting Educator & calmbirth® practitioner based in Sylvania in Sydney and can be contacted on 9544 6441 or visit www.julieclarke.com.au for courses and dates.
Tags: Birth choices, childbirth education
Posted by Melissa Maimann on Oct 26, 2009 in
Birth,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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… obesity cuts the chance of IVF working and increases the risk of premature birth and stillbirth.
… [the] impact becomes more profound as weight increases …
… being overweight and obese affects natural conception too and has a profound impact on a woman and her baby’s health throughout pregnancy and beyond.
… the most obese women … had 35% less chance of falling pregnant and a 59% increased chance of giving birth to a very premature baby …
… “The take-home message … is that women need to reduce their weight before trying fertility treatment.
… “Obesity is a state of inflammation and … It is not conducive to conception and … pregnancy.”
… 32% of women over 16 are overweight … and 21% … are obese …
… being overweight increases the risk of diabetes during and after pregnancy, pre-eclampsia and developing a potentially lethal DVT.
… the chances of recognising foetal abnormalities decrease in overweight and obese women because the quality of ultrasound images falls.
… “Just … losing 5% of their body weight may be enough to restore ovulation in women who are overweight.”
… “Women need to understand that obesity cannot only affect themselves – it can affect their child. If the mother is obese, their child is three times more likely to be obese; and if the father is obese too the child is eight times more likely to be obese.”
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, exercise, intervention, IVF, Nutrition, Preconception care
Posted by Melissa Maimann on Oct 25, 2009 in
Birth,
Midwifery Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
Link
Women would feel more comfortable having their baby delivered by a person who has followed them throughout pregnancy …
… mothers felt much more comfortable when somebody they had met before was with them when they gave birth …
[Continuity of care makes women calmer during the birth] “When they are calm, their body releases more endorphins and they can tackle contractions better,” …
… Between 80 and 90 per cent of women can have a natural birth but they need to prepare for it …
… while it was good to have a birth plan, mothers [need] to be flexible and prepared for the unexpected …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, continuity of care
Posted by Melissa Maimann on Oct 24, 2009 in
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
Link
It was imperative to allow nature to take its course and keep childbirth as normal as possible …
Welsh consultant midwife Grace Thomas said there should not be any medical interventions unless they were absolutely necessary.
Interventions … were like a line of dominos – when one fell, it brought all the others tumbling down.
There have been concerns locally about a high rate of inductions for childbirth …
“If you induce labour … it leads to further interventions …
“Some women do need interventions and it is very important that they are available. But it is imperative to minimise interventions so that women have the chance to give birth normally,” …
… women had the right to information which could allow them to make an informed choice. They should also be able to have an active participation in decision-taking during labour …
It’s important that all births are allowed to proceed naturally: that midwives are skilled at supporting, promoting and protecting natural labour, and that our birth facilities are supportive of natural labour in their design, equipment, policies and staffing. There must be a valid reason to interfere with the normal processes of pregnancy, labour, birth and breastfeeding.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Home birth, hospital birth, intervention, midwife, Midwifery, Midwifery services, Normal Birth, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on Oct 23, 2009 in
Home birth,
Midwifery Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
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More than a thousand New Zealand women each year shun the hospital system and instead give birth in their own lounges, bedrooms and bathrooms. Is homebirth a fringe lunatic choice?
Melanie Patterson describes the scene at her place at first-light last Boxing Day as cosy – she and husband Darren, three-year-old Jake, a friend and the midwife were sitting around eating pancakes with bananas and syrup and chatting about the travel photos on the living-room walls.
Every now and then Melanie had a contraction …
When things became more intense, the friend took Jake to the park, and 45 minutes later his little brother was born into his father’s hands as Patterson leant into the sofa and pushed with all her might.
“Darren just reached out and Juliet [the midwife] told him what to do and he caught Lee,” Patterson says. “That was pretty special. Then we all snuggled up. Jake arrived home and he had a baby brother.”
She says the experience was much less harrowing than her first birth, which included a panicked trip to the hospital after a fast labour and the fear the baby would be born in the car.
“[This time] it was peaceful. It was cosy. I was curled up on the sofa quite a bit, with people around me, getting done whatever I wanted. We had relaxing music and then, later, silence. I was quite open in saying where I wanted the hot towels placed. All my needs were met so I felt really comfortable.”
The Patterson’s choice is not a mainstream one. Health Ministry figures put the percentage of New Zealand women having homebirths at 2.5 per cent …
… homebirth is generally supported by midwives because … it has good outcomes for women who are well and healthy.
“As midwives we want to support women to have a positive birth experience wherever they give birth.”
… when women give birth at home or in a primary birthing unit they are less likely to have intervention in the normal physiology of labour and are therefore more likely to have a normal birth.
… midwives believe home … is … the best place for well women to give birth.
Those with complex pregnancies or medical conditions should go to a secondary or tertiary hospital …
… two Canadian … papers … and a Dutch study … of low-risk women … show no increased risk to mother or baby from planned homebirth and fewer interventions such as forceps and caesarean, even taking into account the women who have to transfer to hospital.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, continuity of care, Home birth, midwife, Midwifery, Midwifery services
Posted by Melissa Maimann on Oct 22, 2009 in
Home birth,
Midwifery Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.
Link
All politics is local, and more often than not personal. Just a fraction of Australians birth at home but their fervour is at times
evangelical. In Canberra’s grey rain this week, 2,000 devoted mums and midwives won a two-year reprieve from being
deregistered and fined if they attend a home birth.
But there were few cheers for Minister Roxon’s back flip. Landmark reform stemming from the recent National Maternity
Services Review proposes autonomy for midwives around prescribing certain drugs and ordering tests as well as long-awaited access to Medicare and indemnity cover. But for home birthing midwives, there will neither be Medicare support nor any form of indemnity protection.
When it comes to the safety of low-risk mums birthing at home, the world’s foremost medical evidence authority is the Cochrane Collaboration. With appropriate hospital support … home birth and hospital mortality for low-risk
bubs is comparable …
A final fillip for home births is that Cochrane acknowledges that outcomes for mums may actually be worse in hospitals
… For many mums, the traumatic hospital experience is the centrifugal force pulling hundreds out of our maternity wards to
deliver at home. Midwives have followed, disenchanted by the “clock-in clock-out” hospital work and the constant turnover
of care. They see hospitals as fragmented, overly medicalised and homebirth as a relationship-based approach rather than a technical exercise in baby delivery. The cascade of hospital interference includes needles and gas, probes and clips
through to forceps, extractors and ultimately caesarean section.
For most of us gadgets and tools are part of the safe baby syndrome, the community expectation that every baby arrives in
perfect health …
… home births exert a counter-pressure upon our hospital system. Birth plans, continuity of care, the demand for fewer interventions and the reemphasis upon emotional attachment to mums are all hospital trends originating from the home birthing movement.
Few realise that the emerging threats to home birthing have more to do with the global financial crisis than any bigotry, intolerance or obstetricians. Late last year, flawed Treasury modelling prescribed a ridiculously large stimulus which threw Australia into debt … it’s too late to recover the cash. Now it’s up to Treasury to claw back the balance sheet. From alcopops and cataracts to IVF and pathology, our health system is paying the price for the ill disciplined spending elsewhere.
Until now the fiscal nips and tucks to our health system have been politically painless … Conception however is the most incendiary moral issue in medicine and our elected officials are about to learn birthing isn’t far behind. Australians rarely march in the streets; certainly not for blood tests or eye operations. But mums choosing home births do so in the context of historical resistance to their choices.
The Health Minister understands that extending indemnity cover to include community midwifery will come at a cost … actuarial analysis is complicated by the infrequency of intranatal misadventure and the potential for multi-million dollar payouts …
The Health Minister’s two-year moratorium is a brief reprieve before home birthing again becomes illegal. Bad policy in two years is still bad policy. Its one thing to decimate home birth by setting up an exclusive “registration” club for midwives which excommunicates those attending home births … Such an approach will draw
quality mainstream midwives out of home birthing and imperil safety.
The Minister would be far better advised to draw midwifery together under a single maternity care system of registration, indemnity and support. Home birthing will never disappear; we owe our mums and their babies a comprehensive system which recognises, insures and drives high quality maternity in hospital and at home …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, continuity of care, freebirth, Home birth, hospital birth, midwife, Midwifery, Midwifery services, women's rights