In a message dated 21/10/1999 23:15:25 GMT Daylight Time,
[log in to unmask] writes:
> I am seeking information regarding midwives using ventouse.
>
> I would like to know
> a) where
> b) when
> and c) any results of evaluations of this use (if any)
> regards
>
> Rosalee
>
In a study undertaken by the European Midwives Liaison Committee on the
twelve then member states of the European Community (now European Union), one
question of the survey asked the statutory bodies, Head midwives and clinical
midwives questions related to the activities of the midwife as defined by the
Activities of the Midwives (European Directive 80/155/EEC).
Several measures to alliviate abnormality were explored:
- shoulder dystocia
- manual removal of placenta
- intra-uterine examination
- vacuum extraction
- forceps delivery
to determine whether or not they were undertaken as part of normal practice
or only in an emergency.
As far as vacuum extraction was concerned, only the statutory authority in
Denmark indicated that this was an activity permitted for its midwives. 9.5%
of the Danish midwives surveyed stated that they undertook vaccuum extraction
as part of their normal practice. 15.8% of the Head midwives in Denmark and
0.6 in the UK allowed it as part of the normal practice of their midwives.
But some midwives indicated that this was part of their normal practice:
Belgium 3.5%
France 3.6%
Germany 1.5%
Greece 2.1%
Netherlands 1.7%
Italy 10.1%
Ireland 1.1%
Luxembourg 2.4%
Portugal 0%
Spain 0.7%
UK 0%
Although it was only allowed by the Statutory authority, a number of Head
midwives reported allowing midwives they were employing to undertake vacuum
extractions:
Belgium 12.1%
Denmark 89.5%
France 10.0%
Germany 8.3%
Greece 7.1%
Netherlands 30.0%
Italy 0%
Ireland 0%
Luxembourg 0%
Portugal 0%
Spain 0%
UK 3.0%
These proportions of midwives reported actually undertaking vacuum extraction
in an emergency:
Belgium 6.6%
Denmark 49.1%
France 14.3%
Germany 16.9%
Greece 5.9%
Netherlands 3.0%
Italy 9.2%
Ireland 1.1%
Luxembourg 4.9%
Portugal 5.0%
Spain 11.6%
UK 0.8%
The questions asked were phrased as follow (in English and translated into
the other eight national languages):
Please indicate whether YOU carry out any of the following, AS PART OF NORMAL
PRACTICE by ringing 'yes' or 'no'
- delivery by vacuum extraction
Second question - identical except that "as part of normal practice" was
replaced by "in an emergency".
I am afraid I do not have information on other countries of Europe or
elsewhere. In this study we did not evaluate the outcome of the procedure
and I am not aware of any study without looking it up in MEDLINE or CINAHL.
I suggest that this would be the first places to investigate for the
effectiveness of the procedure when undertaken by midwives compared to
obstetricians.
I hope this may be helpful.
Marianne Mead
Translator to the European Midwives Liaison Committee
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