Yes Barbara
I have been struggling with understanding how the uterus (and lately the
clitoris) works in pregnancy and labour for the past 25 years and I've
made such real progress that I've even been published in the BJOG
(albeit the debate section but hey, at least it's in print in a
respectable journal). But there has been so little interest from the
'establishment' that I'm losing the will to live.
For me there are two aspects that impinge directly on management of labour:
1. transformation of the uterus from quiescence to active, it it hasn't
yet transformed, induction is a blunt hammer, this directly relates to
2. the fetus plays a role in positioning him/herself for birth - but
struggles to do this in an untransformed uterus and/or one which is
being bombarded with unphysiological amounts of pitocin/syntometrine
(let's start by refusing to call it oxytocin). Hence CS, forceps etc etc
For me freedom of maternal movement (and therefore fetal 'positioning'
movement) is crucial . But hospital management (and/or
obstetricians/lawyers) tethers women to CTG which doesn't work in
'alternative' positions and misses many contractions, even with women in
laid back positions - (electromyography would it the transducers could
be kept in place).
Midwives could do much of this research - even if only 'count the
contractions' with women in different positions. And we have to have a
campaign for better EFM which I believe everyone could agree to, the
technology is archaic.
Physiology research could well change practice. Understanding how it
works will prevent bad practice.
Margaret
On 11/04/2019 08:37, Barbara Hanrahan wrote:
> I think there is a pressing need to inculcate the concept of really understanding physiological birth from a practical care and labour support view point. Health professional training does not FOCUS on practical care that works with the physiological process of labour and birth - certainly my experience in South Africa, current training is heavily influenced by training in the medical model at referral / academic hospitals. Midwives seem to view the accompaniment and hands-on comfort measures for the mother as no longer a part of labour care. Certified doulas ONLY work with that model and their care of a mobile, hydrated, well-supported labour and birthing mothers facilitate the physiological process of birth. Research has shown the measurable outcomes of continuous labur support.
>
> Yes, we need to get a really good teaching model together and work at getting it into basic midwifery training for doctors, nurses and midwives. It would also be a good module to put towards a CPD program that has a number of modules on physiological labour and birth.
>
> I applaud your thinking and efforts.
>
> Barbara Hanrahan: Midwifery lecturer Wits University South Africa. [log in to unmask]
>
>
>
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of Page, Lesley
> Sent: 10 April 2019 02:03 PM
> To: [log in to unmask]
> Subject: Re: More help please!!
> Importance: High
>
> Dear Lesley and Kirstie
>
> Thank you.
>
> I am lecturing on and developing a movement to help shift from medicalisation to humanisation of birth.
>
> I have worked on this idea for many years and am now exploring how to move the approaches forward.
>
> I have spoken on this in many parts of the world and it resonates with many different audiences. I am exploring the possibility of establishing a foundation for the humanisation of birth.
>
> Great that you are doing this
>
> all the best
>
> Lesley
>
> Professor Lesley Page CBE
> Visiting Professor in Midwifery KCL
> Adjunct professor UTS Australia
> Griffith University Australia
> Honorary research fellow Oxford Brookes University
>
> mobile +44(o)7747708630
>
>
>
> https://www.all4maternity.com/author/lesleypage/
>
> <https://www.all4maternity.com/author/lesleypage/>twitter: lesleypageCBE@humanisingbirth
>
>
>
>
>
>
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