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Re: OB:Home Births in AustraliaFrom: Kathi Wilson, BHSc, RM (wilsonk@gtn.net)Thu Aug 27 08:33:20 1998
At Thu, 27 Aug 1998, Peter Wein wrote: > >The authors are careful respected people with lots of epidemiological >experience,and no particular axe to grind about home birth (unlike me). Peter, given the sparks that flew, I think your axe was grinding away just fine ;^). I won't get into specifics, but I will state that it is for just those reasons indicated in the BMJ study that where I practice, it is completely against standard to manage breeches, multiples and documented post-term pregnancies at home. Non-reassuring fetal heart rates not responsive to therapy (or even if, early in labour) and thick meconium are definite reasons to move into a hospital, and by our college standards, thick mec necessitates transferring care to a specialist. We also have practice standards about transport time from the home setting. We are mandated to, and *must* carry two tanks of oxygen, portable suction (not DeLee's but a machine), infant bag and mask, IV set-up and oxytocics (among other things). And we are trained how to use them. In fact, we can't maintain our registration and *be* midwives unless we are yearly certified in Neonatal Resuscitation, and provide evidence of that to our College (unlike physicians who provide obstetrical care).
-- Kathi Wilson BHSc RM Thames Valley Midwives London, Ontario, Canada mailto:wilsonk@gtn.net
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