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The other problem with the notion of labelling women 'high risk' or 'low risk' is that it is so ill-defined: 'at risk' of what? and why? Without those other dimensions, decision making by both midwife and woman is short-circuited. Wonderful to hear Lucia that you are developing a tool that reinforces midwives' (and women's) thinking and decision making. Look forward to seeing what you have come up with. Carolyn Roth Lead Midwife for Education Keele University, School of Nursing & Midwifery Clinical Education Centre Newcastle Road Stoke on Trent ST4 6QG, UK Tel. 01782 55 65 26 Macfarlane, Alison wrote: > > As a statistician, can I point out that using the terms ‘high risk’ > and ‘low risk’ as adjectives to pigeon hole people is completely > fallacious, as is the concept of a dichotomy between high and low > risk. We can use data to estimate a spectrum of risks of various > conditions, but our ability to predict in advance for individual women > is poor. An approach in which midwives use your skills to monitor and > assess the progress of individual women and advise them accordingly > seems much more constructive. Of course it is important to know and > bear in mind that some groups of women have an above average risk of > specific problems, but it is also important to know how high or > otherwise this above average risk is. > > Alison Macfarlane > Department of Midwifery and Child Health > City University London > 20 Bartholomew Close > London EC1A 7QN > Phone (0) (44) 207 040 5832 > Fax (0) (44) 207 040 5717 > Email [log in to unmask] > > www.city.ac.uk > This email and its contents are the property of City University > London. If you are not the intended recipient of this message and any > attached files, please delete it. Unauthorised copying or distribution > of this message, its attachments or parts thereof, is strictly > prohibited unless specifically stated otherwise. > > Please consider the environment before printing my email > > ------------------------------------------------------------------------ > > *From:* Pamela Harnden [mailto:[log in to unmask]] > *Sent:* 04 May 2010 22:40 > *To:* [log in to unmask] > *Subject:* Re: care planning tool for women with uncomplicated pregnancies > > Hi to all, > > I am just wondering about 'risk assessment' etc and wondered if maybe > it may be better to think of things from the reverse perspective. > I was thinking that there can be instances where an obese woman (I was > once one of them) being identified as being 'at risk' of developing > certain complications during pregnancy. I resented being put in this > box during my pregnancies in the UK, I went on to have normal > pregnancies with normal vaginal births. Yet there can be a woman of > average height, average weight who develops a complication and she has > had non of the 'at risk' factors to be labeled with. > > So why not develop guidelines which say if such and such happens then > it is recommended another professional becomes involved in that > woman's care? > > Don't worry if I'm being too simplistic I just hate categorizing > women, labeling them and putting them in a box which sometimes can > lead to a self fulfilling prophecy. > > Cheers > Pam > > On Wed, May 5, 2010 at 7:40 AM, LUCIA ROCCA <[log in to unmask] > <mailto:[log in to unmask]>> wrote: > > Hello, > > I am in the process of developing a care planning tool for women with > uncomplicated pregnancies otherwise called risk assessment tool (Which > I hate...) > > > > I don't want the tool to make midwives switch off their brains..... > > on the contrary I hope it would help the midwife making sense of what > is going on and have an holistic picture of the situation > > help step by step decision making in labour and detect deviation from > normality...... > > > > > > I am working on the task and aiming for the final version to have a > good visual effect and look like a flow chart. > > > > > > Does anybody have a similar tool in their Trust, which I could use to > compare with mine and maybe pick some ideas? > > Thanks > > Lucia > > > > -- > Lucia Rocca-Ihenacho > 115 Greenwich South St > London > SE10 8NX > > 07989 230313 > > > > > -- > Pam Harnden > http://pamdh.wordpress.com > http://www.facebook.com/#/pages/Young-Mums-and-Maori-Antenatal-Classes/180461813792?ref=sgm > http://pamdh.blip.tv/ > http://midwifeblogger.blogspot.com > http://www.youtube.com/Midwifepam > http://nzmidwiferypractisingreflection.blogspot.com > http://midwifepam.wikispaces.com > http://www.google.com/profiles/Pam.Harnden >