Issue 73

Midwifery Today Issue 73Theme: Changing Protocols

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The Bristol Third-Stage Trial

If you set out to compare a policy of intensive, precipitous intervention with a policy of sitting back and watching the patient bleed, obviously the former will be seen to be safer. This was the approach and conclusion of the Bristol Third-Stage Trial. But the trial … is completely misleading… Read more…. The Bristol Third-Stage Trial

Jasmine’s Story: What Are the Limits of “Normal Birth”?

What is a “normal” birth? While this birth was hands-off by medical standards, we used more interventions than usual. Did any of them make a difference? Maybe. Could we have done less? Probably. I realized that this amazing birth was normal. Beth had everything she needed to get her baby born in her own best way.

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Happy Birthday, Birth Change

Midwifery Today turns 19 years old in February of 2005. For me, that is nearly 20 years of working to change birth with Midwifery Today, plus over 10 years of homebirth practice, changing birth one motherbaby at a time. Read more…. Happy Birthday, Birth Change

Protocols vs. Guidelines

The term “protocols” is confusing sometimes because it is used differently from location to location, state to state. In general, protocols have to be very carefully written, or midwives damage themselves legally. Read more…. Protocols vs. Guidelines

Antiretroviral Basics

As midwives, we often struggle against medical interventions that have dubious value for mothers and babies. But a few medical interventions, when used appropriately, are lifesavers. I believe antiretrovirals to be one of these lifesavers.

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A Progressive Midwife in Nazareth

There is a special midwife in Nazareth named Izdihar Abu Eid. Her name means “progress” in Arabic, her mother tongue. She lives up to the name given her by her Bedouin parents and does all she can to advance the cause of her profession, to empower midwives and birthing women.

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Can the Art of Midwifery Survive Protocols?

We must keep in mind that “protocol” derives from the Greek word “kolla,” which means “glue.” To follow a protocol is to give up freedom. Freedom is the prerequisite for any artistic way of behaving. This implies that if it is an art, midwifery is incompatible with the concept of protocol.

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The Air We Breathe – Oxygen: Tradition and Heresy?

Oxygen for resuscitation of newborns was adopted with little research, and maternal oxygen “for treatment of fetal distress” had even less. The use of a high proportion of oxygen was rapidly adopted in the 1970s—not without opposition! Debate continues, even though large studies were designed to settle the questions.

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 Read more…. The Air We Breathe – Oxygen: Tradition and Heresy?

Protocols

We are a profession separate from OBs, paediatricians and physiotherapists; we should not allow others to be responsible for writing our protocols. Yes, where there is overlap, we could work as a team to create guidelines for the working area. But ultimately, we should be creating a framework that works for us.

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Protocols: Finding the Balance

Birth is not fixed, nor should protocols be. The path can be paved for a viable working relationship between institution and midwife. When we transport we must adjust our protocols to include the interventions needed. Establishing a balance that allows protocols to adjust and change is practicing the art of midwifery.

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Marion’s Message: Unchanging Protocols

Marion’s Message: Unchanging Protocols: The basics of birth are unchanging; there is an elemental simplicity. Safe midwifery care during placental delivery and the hours that follow is based on physiological processes and needs that are unchanged over the years. These basic protocols can prevent serious problems for childbearing women.

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Hari’s Birth

In the first scorching hot days of summer our Tamil friends sprang a ceremony on us. My daughter and I were told it was to call out her baby, convincing him of the happy friends awaiting his arrival. We thought he was nowhere near due to stir, not for another nine weeks; but the women planned the event spot on time.

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