Dear Isobel

Thank you for your message.

Since I can't answer all your queries right away, and since you have
suggested I put you in touch with someone who can - I am forwarding your
message to the midwives on three mailing lists, (I've deleted your home
address, as your letter was only addressed to ARM).  These wonderful people
usually respond quite quickly to requests for information (such as yours),
and they will contact you directly via email as well as via the list, since
these are discussion lists, from which everyone learns something every time!

I hope you get a speedy response.

with best wishes
Ishbel Kargar

Please visit our website: www.midwifery.org.uk

Dear List

Please respond to Isobel directly ([log in to unmask] ) if you can give her
any help or information.

Many thanks
Ishbel

-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 26 April 2000 10:19
Subject: Help ...
>Dear A.R.M.,
>
>I wonder if you can help me.
>
>In July 1999 I gave birth to my son and had to have an episiotomy. Months
>later the large amount of scar tissue present lead to corrective surgery.
>Unfortunately since the surgery I still have the scar tissue and am very
>disappointed with the appearance of the area as well. My disappointment has
>caused me to look back at aspects of my labour which I feel had they been
>handled differently could have reduced the chances of my needing an
>episiotomy at all, and thus no need for this 'corrective' surgery.
>
>One of the issues is that I ended up labouring on my back. If there was one
>thing I did not want, it was that! The local hospital says that "it was
>necessary to place me on my back in order to carry out 1. abdominal
palpation
>in order to establish the size, presentation etc of the baby 2. to visually
>inspect the abdomen for scars from previous c-sections which could impact
on
>the labour and 3. to perform a vaginal examination to determine dilation".
>
>My questions are as follows:
>
>1.  is it not at all possible to perform these checks with the woman
kneeling
>in an upright position?
>
>2.  if it is not possible, is there any reason once these checks have been
>performed why the woman couldn't then be helped back into the upright
>kneeling position she had been using up until that point?
>
>3.  if the woman were not helped back into that position, what would you
>consider the reason would be for keeping her supine (knowing that the
labour
>was progressing well and there were no complications etc)?
>
>4.  I would also like to know if you are aware of what guidelines or
clinical
>practice documentation exists with respect to midwifery and if appropriate
>where I could get hold of a copy. I had a fast labour and was in a lot of
>pain but my birth plan stated quite clearly that even if I requested pain
>relief I wanted a ten minute cooling off period before my request was
granted
>during which I wanted to be helped with my breathing/other methods that
might
>assist. What are the guidelines in this situation? Is it standard procedure
>to override that stipulation and go ahead and offer pain relief regardless
of
>what the birth plan says?
>
>I'm hoping you can help me or if not, possibly direct me to someone else
who
>could help me.
>
>Thank you very much for your time.
>
>Sincerely,
>Isobel



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