Posted by Melissa Maimann on Mar 10, 2010 in
Birth,
Caesarean,
Home birth,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Can I home birth if I have a high blood pressure?
It is best to discuss this with your midwife and s/he can guide you on this one.
Can you opt for a c-section in a public hospital?
Generally speaking, you cannot do this. Caesareans are only performed where there is a clear obstetric reason. Many women have support people with them for their labour and this helps them to feel more comfortable and in control of their experience.
Can you refuse midwife attendance during birth?
You can refuse to have a midwife with you if you choose, but this would leave you without professional care during the birth.
What care is available to women birthing in australia?
Within the private system, women may choose a midwife for a home or a hospital birth and they will generally experience an empowering and natural birth without complications. If there are complications in the pregnancy or birth, obstetric care is readily available. The other option in the private system is to choose an obstetrician. Intervention rates with obstetricians are high, with caesarean rates up to (and over) 50%, episiotomy rates around 25% and assisted delivery rates around 25%.
In the public system, midwifery care is the norm, but most women will not have the same midwife all the way through their pregnancy, birth and postnatal period. If there are complications in the pregnancy or birth, obstetric care is readily available.
Continuity of midwifery care
The most established method of continuity of midwifery care is private midwifery care or independent midwifery. In this model, women book with the midwife of their choice and this same midwife is there for the woman throughout pregnancy, birth and the postnatal period. Satisfaction rates with this mode of care are very high.
IVF and home birth?
Yes, it is possible to bith at home following IVF. Talk to your midwife.
Are midwives qualified to do cesareans?
No, midwives are qualified in normal pregnancy and birthing, and we do not perform surgery.
Natural labour in sydney?
The best way to achieve a truly natural labour is to book with a private midwife for a home birth or a hospital birth. Home is the safest place to birth for the majority of women, and home – where women feel safe, nurtured and supported – is the most conducive environment for a natural birth.
Are there any obstetricians in sydney under $5000?
The best way to research prices is to ask the obstetricians themselves. Don’t forget, the ob’s bill is not the only bill you will receive: there is also the paediatrician, anaesthetist, private hospital fees, health fund excess / co-payment, childbirth education and so on.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Caesarean, Complicated pregnancy or birth, continuity of care, Home birth, hospital birth, midwife, Midwifery, Midwifery services, Normal Birth, Obstetrics, Public and private hospitals
Posted by Melissa Maimann on Mar 8, 2010 in
Birth,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
New measurements for determining dangerous blood sugar levels for pregnant women and their unborn babies mean that two to three times as many women will be diagnosed with gestational diabetes …
Instead of 5 percent to 8 percent of pregnant women being diagnosed with gestational diabetes, the new measurements mean that more than 16 percent would be diagnosed with the condition …
The current gestational diabetes measurements are based on blood sugar levels that identified women at high risk for developing diabetes in the future, but didn’t take into account other risks to the mother or baby, including increased risk of overweight babies with high insulin levels, early deliveries, cesarean deliveries, and potentially life-threatening preeclampsia …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth
Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
How long before my due date will my elective caesarean be performed?
Elective caesareans should not be performed before 39 weeks unless there is a genuine reason to do so. This helps the baby’s lungs to mature.
Are there any breathing issues for babies who are born by cesarean?
Yes, breathing difficulties are more common in babies who are born by caesarean. They are not primed by breathing as they are with a vaginal birth, and the fluid in their lungs isn’t squeezed out as is the case with a vaginal birth. As well as this, ceasar babies are more prone to asthma in childhood and adulthood.
What are the pros and cons of caesareans?
I don’t believe there are any benefits to major surgery without sound reason. There are many potential issues with caesareans:
- increased blood loss
- infections
- blood clots
- poor wound healing
- adhesions inside
- increased chance of miscarriage
- lower rate of fertility
- higher chance of tubal (ectopic) pregnancy
- lower chance of ever having a vaginal birth after a caesarean
- increased pain in the recovery period
- poorer bonding
- more breastfeeding problems
- risks associated with anaesthetics
What does it cost to have an obstetrician in Sydney?
Anywhere between $2000 and $10,000.
What does it cost to have a midwife for a home delivery in Sydney?
Usually around $3000 – $5000. This represents fantastic value for money: midwives see their clients for 1-2 hours for each pregnancy visit, they’re there throughout the labour and of course visit the family for 6 weeks after the new arrival has come.
What are the vbac rates in australian hospitals?
Fairly low! Anywhere between 1% and about 30%. The average is around 15%.
Can i have a water birth after a cesarean?
Yes, but you’ll need to choose your care provider wisely. I’d recommend a private midwife. Most hospitals will not officially “allow” a waterbirth.
What is the best hospital in sydney for a natural childbirth?
The best place for a natural birth is not hospital. Home is the best environment for a natural birth, cared for by a private midwife. Your midwife will refer you into hospital if there are any problems, but most home births go very smoothly.
Can I have a home birth after IVF?
Absolutely!
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Caesarean, Home birth, Public and private hospitals, VBAC
Posted by Melissa Maimann on Feb 28, 2010 in
Birth,
Home birth,
Midwifery,
Normal Birth,
Obstetrics,
VBAC Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Why are are home births with a mid wife preferred over a hospital delivery?
There are many benefits to birthing at home and having a midwife provide your care. The following pages will explain more about the benefits of birthing at home:
http://www.essentialbirthconsulting.com.au/home-birth.html
http://www.essentialbirthconsulting.com.au/home-birth/home-birth-benefits.html
I had a bad first birthing experience and I’m now waiting for my second baby.
It’s important to debrief your birth experience to help you to gain clarity around what happened and to explore strategies for helping the same situation to not happen again. Birth debriefing can also help you to choose a care provider who can support what it is you need for your second birth.
What are the benefits of having my baby with a midwife?
There are many benefits:
- Have the same care provider all the way through your pregnancy, birth and postnatal period
- Lower rates of intevention such as forceps, vacuum, episiotomy, induction, epidural
- More likely to breastfeed successfully
- Have continuous support from your midwife throughout labour
- Babies generally experience gentler births
What proportion of women birth at home with midwife?
Australia-wide, around 0.3%. In NSW, it’s around 0.2%. The low rate of homebirth is related to several factors:
- Homebirth is not actively supported by our health system, and hence it is not offered as an option to women when they see their GPs when they become pregnant.
- There is a perception that home birth is something only “hippies” or “alternative” people do. This could not be further from the truth!
- The cost of homebirth is prohibitive for some families as it is totally privately funded.
- In some areas, there are no midwives available.
Is it possible to contract a private midwife for postnatal care only?
Yes! Essential Birth Consulting provides postnatal care independent of birthing services.
Are there any VBAC friendly doctors at north shore private?
VBAC rates at North Shore Private are around 5% or lower and this is reflective of the obstetricians who practice there. Conversely, private midwives have VBAC rates as high as 90%. Obstetricians are surgicial specialists; midwives are specialists in normal, natural birth. If you’re after a normal birth (VBAC), you’re best to choose a care provider who specialises in this.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, continuity of care, Home birth, hospital birth, midwife, Midwifery, Midwifery services, Normal Birth, Obstetrics, Public and private hospitals, VBAC
Posted by Melissa Maimann on Feb 24, 2010 in
Birth,
Caesarean,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
In this world where information is so readily accessible, it never ceases to amaze me how mis-informed and ill-informed some people are when it comes to pregnancy and birth. This article is a prime example:
… As for childbirth being a natural process, yes, that is the case in most pregnancies. I know for a fact that my obstetricians don’t just let their patients go willy-nilly picking when they are tired of being pregnant or delivering babies based upon their Blackberry schedules.
Are you sure? How many caesareans and inductions are scheduled around when their husband will be home, when the doctor will be around, or the time of the year?
Have you seen the malpractice insurance premiums these guys pay? They do everything they can to keep babies and mothers alive.
There is a difference between saving a life that clearly needs to be saved, and saving a life just in case it might need to be saved at some point in the future. Intervening for the latter reason causes unnecessary harm to women and babies.
I don’t believe the majority of C-sections or early inductions are for revenue; they are for saving lives.
See above.
My child was a “complete” breech and if was not delivered via C-section, I and the child would have more than likely died during the “natural process of child delivery.”
Actually, recent research and guidelines support vaginal breech birth. It is sad that you were not informed of this.
Let’s stop C-sections or put a stigma on them and see what happens to mortality rates for mothers and babies.
If recent reports have anything to do with this, then the mortality rate will decline if caesareans reduce.
It seems that society wants a guarantee that the baby process is going to be foolproof and everyone gets the perfect “natural birth process” with no drama or sad outcome.
… it is not my right to have a natural childbirth; it is my privilege to have the best medical care in helping me achieve a healthy and safe delivery of my children.
And the best way to achieve a healthy and safe birth and baby is with a midwife. The midwife will make appropriate referrals to an obstetrician if this is needed.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Caesarean, childbirth education, Complicated pregnancy or birth, Obstetrics
Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
informed consent and childbirth
Every woman who is competent to consent, has the right to refuse any or all professional care. Informed consent must be obtained prior to any procedure being performed.
how to minimise labour intervention in a hospital?
The best way to minimise intervention in a hospital is to be as well informed as you can possible be about all things related to pregnancy, labour, birth, breastfeeding and babies. Read widely, attend independent childbirth education classes and consider employing a private midwife to be with you throughout your labour. She can help you to decide if the proposed interventions are necessary in your situation, she can support you emotionally, mentally and physically and she can aso help to ensure that your birth plan is respected without a fuss.
Do any independent midwives in Sydney offer prenatal care for women who are planning to freebirth?
Yes! This service enables women to access antenatal care from a midwife without the midwife attending the birth. Postnatal care is available if needed.
Do you think there are advantages to continuous monitoring for low-risk women
In a word, no. Intermittent auscultation is the method of choice. Continuous monitoring will increase the chance of a caesarean with no benefit to the mother or baby.
How much is a private midwife
Prices range from $3000 – $6000. Melissa Maimann offers for her clients to pay by the hour, making the service one of the cheapest.
What is a good caesarean rate?
The World Health Organisation recommends that no more than 15% births need to be caesareans. The WHO argues that when caesarean rates exceed 15%, the risks to the mother and baby increase on the whole. You’ll be hard-pressed to find a hospital with a caesarean rate of less than 15%, but birth centres and private midwives have caresarean rates of less than 10-15%.
What is the best hospital in sydney for delivering babies?
It all depends what sort of birth experience you’re after! If you’re wanting a natural birth, home birth will be the best option. If you want a natural birth in a hospital setting, the best options would be birth centre or private midwifery care for a planned hospital birth. If you’re wanting to have intervention in your birth, a hospital birth would be best. If you choose an obstetrician, you’re far more likely to have a caesarean, episiotomy, epidural, forceps or vacuum. Choosing your care provider is the single most important decision you will make in birthing.
Is there a birth centre at westmead hospital?
No, there isn’t. If you’re after a natural birth, the best choice would be a home birth.
C section or natural delivery midwife?
Midwves cannot perform caesareans. If a caesarean was needed, the midwife would call a doctor in to perform it. Most caesareans that are performed are unnecessary and increase the risks to the mother and baby. A natural birth is the safest way to birth, and midwives are qualified specialists in natural birth.
giving birth after birth trauma
Private midwifery care will be really important so that you can have the same midwife all the way through pregnancy, birth and postnatally. It’s also important to debrief your last experience and come to a place where you feel safe to birth again.
high risk midwife sydney
Midwives are not qualified to care for high risk pregnancies. We refer these women onto obstetricians. In most cases, one or two consultations is all that is needed with the obstetrician and the midwife continues the care of the woman.
how many births proceed naturally
What a great question! It all depends what care provider you choose and where you have your baby. You see, if you choose a private midwife and birth at home, you have about a 95% chance of having a vaginal birth. If you birth in a private hospital, you have about a 33% chace of having an unassisted vaginal birth. In some hospitals, the caesarean rate is more than the vaginal birth rate! Sad but true.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Babies, birth, Birth choices, birth debriefing, Birth trauma, Breastfeeding, Caesarean, childbirth education, Complicated pregnancy or birth, continuity of care, Epidural, exercise, fetal monitoring, freebirth, Home birth, hospital birth, intermittent auscultation, intervention, IVF, Maternity Services Review, midwife, Midwifery, Midwifery services, Normal Birth, Nutrition, Obstetrics, postnatal depression, Preconception care, Public and private hospitals, VBAC
Posted by Melissa Maimann on Feb 20, 2010 in
Birth,
Home birth,
Midwifery,
Normal Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
The Federal Government has been grilled at its latest community cabinet meeting over its proposed changes for midwives and maternity services.
The Government wants to make midwifery services eligible for Medicare rebates, but only if homebirth midwives work in consultation with a doctor.
Several women at last night’s meeting … told the cabinet ministers that the changes would restrict the choice of women who only want to give birth with a midwife at home.
But Health Minister Nicola Roxon says the Government is simply taking a cautious approach.
“To make sure we’ve got some backup protocols in place, so if something does go wrong that there are agreements with the hospital or doctor to be able to step in quickly,” she said.
“And that is a conservative approach, but it isn’t a conservative approach to say midwives are doing good work, have never been recognised in the history of providing Medicare for the last 50 years and we’re going to actually change that.”
She told the meeting that medical professionals should be working together.
“I’m unapologetically on the record as saying let’s encourage people across the health services spectrum to work together and make sure that women can safely choose options that are good for them and suit them,” she said.
Women who access private midwifery services will be able to access Medicar benefits. As well as this, midwives will be able to order medications via the PBS.
The maternity reforms provide women with greater access to continuity of midwifery care. The standard care in a public hospital is for women to see one group of midwives in the clinic, another group in the delivery suite (who work shifts) and then another lot of midwives when they are being cared for with their baby. The maternity reforms will make it possible for more women to be cared for by their own midwife, whom they have chosen. The same midwife will provide care from the first antenatal consultation right up until about 2-4 weeks after the baby is born.
This is a huge step forward for Australian maternity care. For the first time, women will be able to birth in hospital under the care of a private midwife. Private midwifery care will also be available for home births (as is currently the case). We are continuing to book women for home births beyond July.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, continuity of care, hospital birth, Maternity Services Review, Midwifery, Midwifery services, Normal Birth, Public and private hospitals
Posted by Melissa Maimann on Feb 16, 2010 in
Birth,
Caesarean,
Midwifery,
Normal Birth,
Obstetrics Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
Being overweight or obese increases a woman’s chances of having an extra-big baby …
Excess weight in and of itself also sharply increased a woman’s risk of pre-eclampsia …
Women have more difficulty delivering very large babies, while these newborns are also at risk of suffering injury during birth, including shoulder dislocation. While women who are overweight or obese are known to run a greater risk of having very large babies and experiencing other pregnancy complications, it has been difficult to separate out the effects of a mother’s weight from those of gestational diabetes …
This led them to investigate whether BMI … a standard measure of weight in relation to height used to gauge how fat or thin a person is — might influence pregnancy risks and fetal and newborn health, independently of a woman’s blood sugar levels.
… women with BMIs of 42 or greater … were at more than triple the risk of having an excessively large baby, compared to the thinnest women in the study …
The heaviest women’s risks of having a C-section were more than doubled, while their likelihood of pre-eclampsia was 14-fold greater than for the leanest women …
… dietary changes can effectively treat gestational diabetes for more than 90 percent of women with the condition.
“… treating gestational diabetes going forward is going to continue to be beneficial,” the researcher said. “We have much less evidence at this point as to how to neutralize or reduce the impact of overweight on pregnancy outcome.”
… it’s probably a woman’s weight before she gets pregnant, rather than how much she gains during pregnancy, that’s important in determining risk.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Complicated pregnancy or birth, exercise, intervention, Normal Birth, Nutrition, Preconception care
Posted by Melissa Maimann on Feb 8, 2010 in
Birth,
Midwifery,
Normal Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
The use of epidurals in Ireland during labour has roughly doubled over the past 20 years. “This development isn’t a good thing. Because of the increased risk of potential complications during childbirth, administering an epidural during labour is not only undesirable — it’s also often unnecessary.”
That is the message from Dr Denis Walsh, Associate Professor of Midwifery at the University of Nottingham, who says a more naturalistic approach to labour-pain management should be considered.
… “There’s a physiological purpose to labour pain; it’s a natural state rather than a problem. So normal labour shouldn’t need to be treated as a pathology,” said Dr Walsh.
“Administering an epidural can interfere with the body’s natural responses. During labour the body releases endorphins, which not only affect the state of consciousness, but also stimulate movement. Studies have shown that walking and increased physical activity during labour can assist in the process.” An epidural, in most cases, requires that a woman remain in bed.
… Epidurals have been shown to increase the duration of labour, and cause a decrease in oxytocin. Additionally, the baby may become malpositioned to transverse or posterior.
Studies have shown a correlation between the use of epidurals and an increase in the use of forceps to aid delivery, by up to 40 per cent, and some recent research has indicated that epidural anaesthesia can lower prolactin levels in response to breastfeeding in the days following birth.
… women need to be presented with all the information regarding epidurals before undergoing anaesthesia. … “Some 50 per cent [of anaesthetists] didn’t mention the risk of intervention with forceps. The need to communicate all the risk factors is essential.
“… if a woman is in severe distress, or there are complications, of course it should be administered.
“But during a normal birth, there are other ways to make the mother more comfortable,” …
“… it’s the support given to the mother, not pain management, that’s the more significant factor in a positive experience of childbirth. Key to a positive experience is one-to-one support from a midwife.
“… One-to-one support has been shown to reduce the number of Caesareans carried out, and reduces the number of epidurals. A midwife can help in pain management both physically, for instance [with] massage, and psychologically, by offering emotional support.”
Dr Walsh suggests that access to water-immersion facilities … could reduce the need for epidurals. There is evidence to show a correlation between water immersion during the first stage of labour and a reduction in the use of epidurals …
It’s my experience that women who are well prepared for labour and who are supported in their labours with one-to-one midwifery care, do not need epidurals. A mere 3% of women who use my services choose an epidural for their labours and 80% use no pain relief at all.
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, childbirth education, continuity of care, Epidural, Midwifery
Posted by Melissa Maimann on Feb 7, 2010 in
Birth,
Midwifery,
Normal Birth Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.
Link
Despite fewer epidurals, the majority of women in midwife-led units were happy with their pain relief.
MOST IRISH first-time mothers opt for the epidural … But reducing the pain levels doesn’t necessarily mean a more satisfying birth experience …
The HSE report involved a study of … women who had babies in the Midwifery-led Units (MLUs) … despite having fewer epidurals, 83 per cent of women in the midwife-led units expressed satisfaction with their pain relief, compared with 68 per cent of women in the consultant-led unit.
… midwife-led care was as safe as consultant-led care, resulted in less intervention, gave birthing mothers greater satisfaction and was more cost-effective.
… the epidural was very effective in complicated labours, for example where the birth was being induced or sped up.
However, in normal pregnancy … three forms of care reduced epidural use: one-to-one care in labour given by a midwife; access to water immersion, … and access to self- hypnosis or hypnobirthing.
“When those three forms of care are widely available for women, we see quite a low rate of epidural, even in first-time births. These forms of care are available in birth centres and in home birth situations … ”
… the downsides of epidural use … included an increase in forceps or vacuum delivery, a lengthening of labour and an increased need for oxytocic drugs to induce labour.
“Research on women’s satisfaction with labour has found that the one-on-one support they got from the midwife was a much more important part of the actual experience than the experience of pain. Paradoxically, a lot of women talk about a high level satisfaction along with a high level of pain.”
Dr Peter Boylan … had a different opinion … “The epidural is undoubtedly the most effective form of pain relief … for a first birth … A lot of women find that it transforms what is a miserable experience into one they actually enjoy because they are not suffering the awful pain,” he said …
Melissa Maimann, Essential Birth Consulting 0400 418 448
Tags: Birth choices, Epidural, Home birth, hospital birth, midwife, Midwifery, Midwifery services, Normal Birth