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Re: OB:Home Births in Australia From: Kathi Wilson, BHSc, RM (wilsonk@gtn.net) Thu Aug 27 19:58:02 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Betsy Hyde: "Re: Gyn: OCPs" Previous message: Gail Waldby, MD: "Re: Gyn: OCPs" In reply to: Peter Wein: "Re: OB:Home Births in Australia" Next in thread: Peter Wein: "Re: OB:Home Births in Australia" Reply: Peter Wein: "Re: OB:Home Births in Australia" At Fri, 28 Aug 1998, Peter Wein wrote: > >> 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, > >Without CTG, how do you know that the fetal heart rate is "non-reassuring" >- or do you carry this around as well? We carry dopplers, and we listen per standards set out by the SOGC for intermittent auscultation, which is, by both SOCG and ACOG (as I understand it), a perfectly acceptable level of care. If we hear anything we don't like, we transport. I would hope that you're not routinely using electronic fetal monitoring on labouring women. > >>We also have practice standards about transport time from the home setting. > >I understand Canada is a big country like Australia - and probably has the >same traffic problems in the big cities - how do you cope with rural >settings and peak hour traffic? The same as all emergency services do. Lots of women live extended distances from obstetric services...not uncommon for women to have babies in cars, in this part of the world. >But then the physicians who provide obstetric care do so in hospitals where >there are pediatricians. And the article made the point that not all home >birth practitioners are registered midwives - nor is there any requirement >for them to be registered. Sorry, Peter, that is *absolutely* not true. There are many level I hospitals in this province that are staffed only by family physicians. Now, the conscientious ones do get certified in NRP. But they are not *required* to do so. Only in major centres are there pediatricians in-house; that is the exception, not the rule. In Ontario, home birth practitioners *are* registered midwives. Those who are not (or who are not physicians, and it's extremely rare for physicians to provide homebirth) are practicing illegally. Plain as that. They sure wouldn't be offering up any statistics for case review. -- Kathi Wilson BHSc RM Thames Valley Midwives London, Ontario, Canada mailto:wilsonk@gtn.net Next message: Betsy Hyde: "Re: Gyn: OCPs" Previous message: Gail Waldby, MD: "Re: Gyn: OCPs" In reply to: Peter Wein: "Re: OB:Home Births in Australia" Next in thread: Peter Wein: "Re: OB:Home Births in Australia" Reply: Peter Wein: "Re: OB:Home Births in Australia"

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