Dear Carmel and anyone else who is wondering about
this,
Yes, the ideas do cut across the lists. The idea of
the new one is that it has an explicitly research
focus - it is for researchers who want to set up
formal research collaborations in this area, or who
want to bounce research ideas around. This does not
mean, however, that the information is not more
generally applicable, and those of us who are on both
(or even more) lists will continue to cross-pollinate.
I do understand the problem of list proiferation and
efatigue - however, I hope that in this case the new
list will serve a different but complementary purpose.
best wishes
Soo
--- "Collins, Carmel (NUR_MID_RES)"
<[log in to unmask]> wrote: > Dear Soo and list
members,
> Just a thought - would the discussions you are
> trying to set up on a
> separate list work within this forum, it seems they
> are ideally suited?
> Kind regards
> Carmel Collins
> Adelaide, Australia
>
> -----Original Message-----
> From: Soo Downe [mailto:[log in to unmask]]
> Sent: Sunday, 3 June 2001 08:03
> To: [log in to unmask]
> Subject: Re: Guidelines for midwifery led care in
> labour
>
>
> Dear Maggie,
>
> I would be very interested in exploring your ideas
> about physiological birth based on a midwifery
> philosophy. This is a passion on mine, and I am
> trying
> to set up ways of making this embodied knowledge
> overt
> and accessible so that midwives and women can begin
> to
> believe in it again. It seems like the idea of
> salutogenesis (the generation of well-being - the
> opposite of pathogenesis) may offer some solutions.
> With Jane Sandall I have set up a list which is
> trying
> to bring people together to discuss ways of finding
> our about birthing within a midwifery philosophy.
> This
> includes ways of trying to find a kind of evidence
> which doesnt only work for populations, but for
> individuals. If you would be interested in this,
> please contact me on [log in to unmask] (this goes
> for anyone else who is interested in this topic).
>
> By the way, I am sure that Jane and Helen would
> agree
> with you.
>
> best wishes
>
> Soo
> --- Maggie Banks <[log in to unmask]> wrote: > Hello
> list members
> > I have spent the last week trying to compose a
> > letter to Jane Munro & Helen Spiby, the authors of
> > the Guidelines for midwifery led care in labour
> that
> > appeared recently on the list. (I have actually
> lost
> > their email so would appreciate this being
> forwarded
> > to them if they are not on the list.)
> >
> > I wish to acknowledge the huge amount of work that
> > has gone into this project but I have to admit to
> > feeling very uneasy about the result. I have made
> an
> > assumption this list is not just about resource
> > sharing but also about debate and the exchange of
> > ideas.
> >
> > To introduce myself I am a home birth midwife and
> > writer in New Zealand. I have had the opportunity
> to
> > develop a belief system around birthing that is
> not
> > governed by obstetrics (as it was when I worked in
> > the hospitals from 1969-1990). Since 1989 I have
> > been taught about 'normal' birthing by the women I
> > have cared for in home birth as I have gone about
> > providing sole midwifery care (which is how we
> term
> > 'midwifery led care' except it is done in
> continuity
> > of care).
> >
> > The underlying theme of Jane's and Helen's
> > Guidelines seems to have been to pick apart
> > obstetric practice in the hope of exposing what
> > midwifery care is all about, rather than looking
> to
> > how it is that women birth; what their needs are
> and
> > how a midwife can impact positively within the
> > relationship. The issues of birth environment;
> > nutrition in labour; positions in labour and
> birth;
> > rupture of membranes; placental delivery; care of
> > the newborn in the Guidelines are all worked to
> > counter the negative effects of interference. If
> > indeed midwives do believe in birth as a real or
> > potential physiological event why is so much
> > emphasis placed on gathering evidence to show
> > obstetric care is detrimental to normal birthing?
> > Why are the physiology; biology and sociology of
> > childbirth not the focus of these Guidelines?
> >
> > To give a small example - the physiological means
> of
> > assessing the unborn baby in the labour situation
> > has been ignored. Instead the RCOG guidelines for
> > monitoring has been adopted - a regime which will
> > undoubtedly ensure that the woman is disturbed in
> > the physiology of birthing. Isn't it more
> > appropriate to evaluate the unborn baby's wellness
> > state in a way that does not interrupt the woman
> in
> > her labouring? The noting of a baby's movements in
> > pregnancy is a well-accepted assessment of the
> > unborn baby's wellness and integral to both
> > midwifery and obstetric practice. The majority of
> > babies whose mothers are neither sedated nor
> > anaesthetized in labour continue to have periodic
> > movements. This phenomenon is based on my own
> > experience of nearly thirteen years of caring for
> > women in spontaneous and non-medicated childbirth
> at
> > home. My observations are supported by the
> > literature that confirms the different behavioral
> > states that exist in pregnancy, where healthy
> unborn
> > babies have distinct periods of sleep and
> activity,
> > continue to be present in labour. [1]; [2]; [3].
> In
> > labour, as in pregnancy, the unborn baby's
> movements
> > are accompanied by accelerations of the baby's
> heart
> > rate. Again, these are a sign of the baby's
> wellness
> > and are a normal, healthy response to the normal
> and
> > healthy stresses (not distress) of labour.[4] The
> > difference between the Medical and Midwifery
> Models
> > of Care is that the former values machinery to
> > assess and verify movements of the unborn baby
> [5],
> > [6] whereas the latter validates verbal feedback
> by
> > the woman and/or visual or tactile observation by
> > the midwife.
> >
> > Very simply put - if midwives do believe in
> > physiological birthing, Guidelines that attempt to
> > frame evidence based and appropriate practice
> should
> > reflect activities that at best enhance the
> process
> > or at worst do not interfere with it.
> >
> > I contemplated not writing and then not sending
> this
> > posting as I am from a different birth culture
> than
> > the obstetric environment but I was driven to do
> so
> > for one reason. If we are quiet about such
> > Guidelines that silence can be taken as tacit
> > approval. While the authors have stated their
> > intention not to be prescriptive, the practice
> > reality so often actions such Guidelines in a
> > prescriptive manner and they become standard
> > practice.
> >
> > My thoughts are offered in the spirit of universal
> > midwifery.
> >
> > Regards
> > Maggie Banks
> > website www.birthspirit.co.nz
> >
> >
>
----------------------------------------------------------------------------
> ----
> >
> > [1] Griffin RL, Caron FJ van Ciijn HP. (1985,
> August
> > 1) Behavioral states in the human fetus during
> > labor. American Journal of Obstetrics and
> > Gynecology. 152 (7 Pt 1): 828-833.
> >
> > [2] Yarkoni S & Hobbins JC. (1987) Intrapartum
> fetal
> > activity. Journal of Perinatal Medicine. 15 (3):
> > 316-322.
> >
> > [3] Banks M. (2000) Home Birth Bound: Mending the
> > broken weave. Hamilton: Birthspirit Books. Pp
> > 98-100.
> >
> > [4] Rabinowitz R, Persitz E, Sadovsky E. (1983,
> > January) The relation between fetal heart rate
>
=== message truncated ===
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