Wednesday 23 December 2009
Home-birth boost for expectant mothers
Hospital provided homebirth pilot project
Those of you old enough to remember will remember the fanfare and Commonwealth money dished out to fund midwifery model of care pilot programs following the Shearman report in the late 80's. Many programs were funded in the early 90's. As soon as the money ran out, however, those models fell over and childbearing women across the country were left high and dry, with no midwifery service. The only model to survive those halcyon days was the Community Midwifery practice in Perth, Western Australia. The only reason that model continued was because the state government at the time agreed to fund it.
Time will tell if this is a Wizard of Oz or Emperor's New Clothes situation or not. The government may be sincere in wanting women to have true choice, however true choice means equity for all health professionals, not just those with the most money and the most power.
A disturbing aspect to this pilot project is that the government is hoping that private midwives will want to work in the program and become state funded employees. While that sounds good on the surface, the reality is that along with state funding comes state rules and regulations which is where the problems start for some people. Midwives who work privately do so because they want to work in their full scope of practice and be 'there' for those women who request their services. That means being on call for those women. With state run services there are rules about how many days you can work, how many hours you can work, who you can work with and how you do your work. Depending upon how the project is structured, women may or may not know who will attend them for their birth; they may not know the midwife on the other end of the phone when they ring in labour. Those rules and regulations are designed to protect the institution. Because the rules and regulations are designed for institutional needs, not the birthing woman's needs, they end up creating a 'cookie cutter' approach to maternity care work. A birthing woman does not necessarily fit neatly into a proscribed pattern of care provision. Privately practising midwives I know choose to work as a contracted employee of the woman, within their scope of practice and according to their professional requirements, not contracted by the state to have their working schedule dictated by rules and regulations for government purposes. Private midwives primary focus is on the woman and what her needs and desires for the birth of her baby were. Serving two masters never works.
An article which explored the ethics of caring for nurses in the health care system identified three ways that nurses align themselves. The first way is aligned with the institution, the second, aligned with doctors and the third, aligned with 'patients'. Midwifery ethics, as described by Fay Thompson, are clearly 'with woman'. While some privately practising midwives may be interested in working in state run institutions, others are not going to be interested in working for the state.
Apart from the right to work in way that is aligned with one's ethical and professional values, our profession needs privately practising midwives. Midwives in private practice demonstrate what midwifery care is at its essence and provides an inspirational role model for future midwives. Midwifery knowledge and wisdom, which has, in institutionalised maternity care, been subsumed under the technocratic approach to childbirth of the medical model, is held and passed on by privately practising midwives.
To sum up, this pilot study is welcomed, but this year long program, even if it continues, does not take the place of ensuring there are robust structures in place for the continuation and support of private midwifery and a woman's choice to birth with someone she knows and trusts.
Home-birth boost for expectant mothers
JULIA MEDEWThe provision of state funded homebirth services is a welcome sign of change in attitude towards the normality of birth, at least in the eyes of politicians and health care service bureaucrats. However, this pilot scheme is funded for one year. What happens after that is anyone's guess. The skeptic in me is suspicious that this 'offer' is to mollify the insurgents and designed to keep people quiet. Given the groundswell of support from the community for privately practising midwives to provide homebirth services for women who want to birth at home, that is a reasonable suspicion.
December 23, 2009VICTORIAN women will be able to give birth at home - with hospital back-up for the first time - under a pilot project starting at three hospitals next year.
Health Minister Daniel Andrews said yesterday that the State Government had allocated $400,000 for midwife-led home births through Casey Hospital in Berwick and Sunshine Hospital in Melbourne's west. A regional health service will also participate, but the Government has yet to decide which one.
Those of you old enough to remember will remember the fanfare and Commonwealth money dished out to fund midwifery model of care pilot programs following the Shearman report in the late 80's. Many programs were funded in the early 90's. As soon as the money ran out, however, those models fell over and childbearing women across the country were left high and dry, with no midwifery service. The only model to survive those halcyon days was the Community Midwifery practice in Perth, Western Australia. The only reason that model continued was because the state government at the time agreed to fund it.
Time will tell if this is a Wizard of Oz or Emperor's New Clothes situation or not. The government may be sincere in wanting women to have true choice, however true choice means equity for all health professionals, not just those with the most money and the most power.
A disturbing aspect to this pilot project is that the government is hoping that private midwives will want to work in the program and become state funded employees. While that sounds good on the surface, the reality is that along with state funding comes state rules and regulations which is where the problems start for some people. Midwives who work privately do so because they want to work in their full scope of practice and be 'there' for those women who request their services. That means being on call for those women. With state run services there are rules about how many days you can work, how many hours you can work, who you can work with and how you do your work. Depending upon how the project is structured, women may or may not know who will attend them for their birth; they may not know the midwife on the other end of the phone when they ring in labour. Those rules and regulations are designed to protect the institution. Because the rules and regulations are designed for institutional needs, not the birthing woman's needs, they end up creating a 'cookie cutter' approach to maternity care work. A birthing woman does not necessarily fit neatly into a proscribed pattern of care provision. Privately practising midwives I know choose to work as a contracted employee of the woman, within their scope of practice and according to their professional requirements, not contracted by the state to have their working schedule dictated by rules and regulations for government purposes. Private midwives primary focus is on the woman and what her needs and desires for the birth of her baby were. Serving two masters never works.
An article which explored the ethics of caring for nurses in the health care system identified three ways that nurses align themselves. The first way is aligned with the institution, the second, aligned with doctors and the third, aligned with 'patients'. Midwifery ethics, as described by Fay Thompson, are clearly 'with woman'. While some privately practising midwives may be interested in working in state run institutions, others are not going to be interested in working for the state.
Apart from the right to work in way that is aligned with one's ethical and professional values, our profession needs privately practising midwives. Midwives in private practice demonstrate what midwifery care is at its essence and provides an inspirational role model for future midwives. Midwifery knowledge and wisdom, which has, in institutionalised maternity care, been subsumed under the technocratic approach to childbirth of the medical model, is held and passed on by privately practising midwives.
To sum up, this pilot study is welcomed, but this year long program, even if it continues, does not take the place of ensuring there are robust structures in place for the continuation and support of private midwifery and a woman's choice to birth with someone she knows and trusts.
Home-birth boost for expectant mothers
Tuesday 22 December 2009
Social construction of Childbirth - how the media works
A new film called "Labouring under an Illusion" shows the way that childbirth is portrayed in the media. The film makers juxapose the often comical, always fear inducing media perspective with normal, healthy, calm birth footage. The presentation of the two points of view provides an excellent reality check.
Here's the trailer for the video
Vicki Elson, a childbirth educator, explains her motivation for making the film during an interview with
"I was doing a workshop for nurse-midwives at a local hospital when a particularly ghastly and unrealistic (and Emmy-winning) episode of “E.R.” came out. The midwives said their phones were ringing off the hooks because moms were scared that they could die like the lady on TV. Meanwhile, Murphy Brown was America’s liberated TV mom who could anchor the news and stand up to Dan Quayle. But in labor, she was wilted and powerless, except when she was strangling men by their neckties. I wanted my kids and their friends to grow up with realistic, nourishing imagery about the power of their bodies to do normal things like have babies. I was working with midwives Rahima Baldwin Dancy and Catherine Stone on a workshop called “Empowering Women in the Childbearing Year,” and we started collecting clips to show childbirth educators what they were up against from the culture. It’s still a struggle to compete with compelling but unrealistic imagery that sticks in people’s minds. I expanded on that project to write my master’s thesis 10 years ago, and when the kids grew up I finally got around to updating the project and putting it on DVD so it’s more useful and accessible.”
Well done Vicki! Resources like this are essential to counter the negative publicity that childbirth is subject to. For more information on the video or to order a copy, visit Birth-Media.com.
Amy Romano on Science and Sensibility blog has an excellent post on Childbirth Literacy that includes this video trailer and information. http://www.scienceandsensibility.org/
Breastfeeding is Normal
The women who made this video said:
"The purpose of our video is to encourage mothers to feed their child, no matter where they are! And to give encouragement to new and expecting mothers that breast is best, and nursing IS normal".
YouTube - NIN CHARLOTTE
"The purpose of our video is to encourage mothers to feed their child, no matter where they are! And to give encouragement to new and expecting mothers that breast is best, and nursing IS normal".
YouTube - NIN CHARLOTTE
Midwifery-led maternity care safe
HSE.ie - Health Service Executive Website - Presentation of the “MidU” study – a major trial comparing midwifery-led and consultant-led maternity care
"The 'MidU' ('Midwifery Unit') study showed that midwifery-led care, as practised in these units, is as safe as consultant-led care but uses less intervention in pregnancy and childbirth".
What's interesting is that the report says midwifery care is as safe as consultant care. My reading of the statistics means that midwifery care is safer than consultant care for that group of women.
"The 'MidU' ('Midwifery Unit') study showed that midwifery-led care, as practised in these units, is as safe as consultant-led care but uses less intervention in pregnancy and childbirth".
What's interesting is that the report says midwifery care is as safe as consultant care. My reading of the statistics means that midwifery care is safer than consultant care for that group of women.
Honoring Embodied Wisdom
I was exploring the peaceful birth project's wall (http://www.thepeacefulbirthproject.com/) on Facebook and came across the article about perineal integrity from Midwifery Today 2005.
Honoring Body Wisdom - by Pamela Hines-Powell
Pamela has some wonderful insights including:
"... there are very few things I personally can do to really prevent tearing in a client, but there are a whole host of situations and instances where I could actually create an environment for perineal tearing".
Our role as midwives is to create the environment where a woman can find her own way, get in touch with her inner power, her inner intelligence and innate guidance system. A woman can find her own way when there is an atmosphere of loving, capacity building trust in the process of birth and the woman's ability that the midwife engenders by having a mindful approach to her role in creating that environment. A mindful approach for the midwife involves awareness of and congruency in her intention, focus, thinking patterns, body language, movement and words. A midwife's mindful approach also includes attention to those aspects of the woman she is working with. Such an environment optimises a woman's birthing psychophysiology. A woman's optimal birthing psychophysiology means her mind, body and spirit are in harmony, her brainwave patterns are in gamma, alpha, theta and delta wavebands (known as a 'flow' state) a relaxed, focussed mode; her brain's attentional networks are focused on her baby and her baby's impending birth; the woman is able to let go of her orienting and alerting brain networks with their beta brain waves. When a woman is able to be in that biobehavioural state, genetic switches are flipped to parasympathetic mode; oxytocin and endorphins flow and the woman is able to respond instinctively to her body cues; labour progresses and birth happens.
Pamela asks a really good question: "As midwives, are we finding ways to support women's instinctive behaviors or do we undermine their instincts by directing them?"
How we look, how we move, everything we do and say has an effect on the labouring woman.
Pamela writes:
"The birthing woman is highly susceptible to suggestion—even if very subtle. For instance, a midwife lays a chux pad on the bed. The message received is "sit here"—many women will follow the placement of the chux and reside wherever it is placed, even if there is no spoken direction by the provider. However, left to her own devices, a woman will rarely lie down to push her baby out".
There is so much wisdom in that information. The first job for a midwife on the learning curve of being 'with woman' is to understand and integrate that truth into their practice.
I'm reminded of the words of the wonderful Nicky Leap, a brilliant midwife. Nicky said "the less we do, the more we give". That 'doing less' has to come from a position of trust in birth, trust in women's innate capacity to give birth well as well as being mindful of what is happening with that woman, her baby and the labour process. 'Doing less' is not about being lazy or lassez faire about women and birth. Doing less, is actively mindful, fully present and conscious in the moment, actively aware of the ebb and flow of labour and birth; being a source of feedback for the woman when required; subtly monitoring the woman, her baby and her experience; ready to support adjustment if needed. 'Giving more' in this context means that a woman who is supported to be instinctive feels powerful, her capacity is strengthened, she emerges from labour and birth feeling amazing. Barbara Katz Rothman says that birth is about building strong, capable mothers as well as welcoming new life into the world.
As midwives, we can create a safe, nurturing, protective environment where a woman can express her individuality, her innate wisdom and feel free to make the changes needed in becoming a mother. We can provide a supportive environment within which a woman can empower herself, find her innate power and utilise it; we can't empower her. We can however, disempower. We can 'pull the rug' from underneath a woman, destabilising her so she doubts herself and loses her confidence.
Pamela's question is a good one. We can extend that question and ask ourselves "am I creating an environment where a woman feels safe to be herself and does she feel better about herself when she leaves my presence?" We need to ask ourselves that frequently. We need to ask the women we work with for feedback about that too.
Honoring Body Wisdom - by Pamela Hines-Powell
Pamela has some wonderful insights including:
"... there are very few things I personally can do to really prevent tearing in a client, but there are a whole host of situations and instances where I could actually create an environment for perineal tearing".
Our role as midwives is to create the environment where a woman can find her own way, get in touch with her inner power, her inner intelligence and innate guidance system. A woman can find her own way when there is an atmosphere of loving, capacity building trust in the process of birth and the woman's ability that the midwife engenders by having a mindful approach to her role in creating that environment. A mindful approach for the midwife involves awareness of and congruency in her intention, focus, thinking patterns, body language, movement and words. A midwife's mindful approach also includes attention to those aspects of the woman she is working with. Such an environment optimises a woman's birthing psychophysiology. A woman's optimal birthing psychophysiology means her mind, body and spirit are in harmony, her brainwave patterns are in gamma, alpha, theta and delta wavebands (known as a 'flow' state) a relaxed, focussed mode; her brain's attentional networks are focused on her baby and her baby's impending birth; the woman is able to let go of her orienting and alerting brain networks with their beta brain waves. When a woman is able to be in that biobehavioural state, genetic switches are flipped to parasympathetic mode; oxytocin and endorphins flow and the woman is able to respond instinctively to her body cues; labour progresses and birth happens.
Pamela asks a really good question: "As midwives, are we finding ways to support women's instinctive behaviors or do we undermine their instincts by directing them?"
How we look, how we move, everything we do and say has an effect on the labouring woman.
Pamela writes:
"The birthing woman is highly susceptible to suggestion—even if very subtle. For instance, a midwife lays a chux pad on the bed. The message received is "sit here"—many women will follow the placement of the chux and reside wherever it is placed, even if there is no spoken direction by the provider. However, left to her own devices, a woman will rarely lie down to push her baby out".
There is so much wisdom in that information. The first job for a midwife on the learning curve of being 'with woman' is to understand and integrate that truth into their practice.
I'm reminded of the words of the wonderful Nicky Leap, a brilliant midwife. Nicky said "the less we do, the more we give". That 'doing less' has to come from a position of trust in birth, trust in women's innate capacity to give birth well as well as being mindful of what is happening with that woman, her baby and the labour process. 'Doing less' is not about being lazy or lassez faire about women and birth. Doing less, is actively mindful, fully present and conscious in the moment, actively aware of the ebb and flow of labour and birth; being a source of feedback for the woman when required; subtly monitoring the woman, her baby and her experience; ready to support adjustment if needed. 'Giving more' in this context means that a woman who is supported to be instinctive feels powerful, her capacity is strengthened, she emerges from labour and birth feeling amazing. Barbara Katz Rothman says that birth is about building strong, capable mothers as well as welcoming new life into the world.
As midwives, we can create a safe, nurturing, protective environment where a woman can express her individuality, her innate wisdom and feel free to make the changes needed in becoming a mother. We can provide a supportive environment within which a woman can empower herself, find her innate power and utilise it; we can't empower her. We can however, disempower. We can 'pull the rug' from underneath a woman, destabilising her so she doubts herself and loses her confidence.
Pamela's question is a good one. We can extend that question and ask ourselves "am I creating an environment where a woman feels safe to be herself and does she feel better about herself when she leaves my presence?" We need to ask ourselves that frequently. We need to ask the women we work with for feedback about that too.
Sunday 20 December 2009
Mothers held to ransom as breast milk sharks charge $1000 | The Courier-Mail
December 20, 2009 12:00am
A BLACK market in breast milk has developed in Australia as families desperate to feed their babies the natural elixir are being charged up to $1000 a litre on the internet.
Mothers held to ransom as breast milk sharks charge $1000 | The Courier-MailThe news comes after The Sunday Mail revealed last week that the Gold Coast milk bank – which receives no government funding – may have to close in February if it doesn't raise $50,000 through donations or sponsorship to cover the cost of its pasteurisation unit.
RMIT (Royal Melbourne Institute of Technology) lactation expert Dr Jennifer James said she was aware of the growing unregulated black market.
"It is very dangerous because in an unregulated fashion there are no checks and balances, the milk would not have been tested for viruses and bacteria," Dr James said.
"Women are being put in this insidious position because of a lack of breast milk banks nationally.
"They have no option but to look outside the system."
The risky practice has increased with the advent of the internet where women advertise their milk for sale".
Midwifery takes a northern look: UofA program supports Nunavit women to birth at home
U of A program supports Nunavit women to birth at home
"A healthy community has to be one where women can give birth," said O'Brien, who has been travelling to Nunavut for three years to speak with traditional midwives, most in their 80s. They share stories of feeding the best cut of meats to expectant mothers and delivering babies in ice houses, or tents made of furs. That history is informing the new midwifery program"
The aim of the program is to train midwives locally so more Nunavut mothers can give birth in their home communities.
Kango, a traditional midwife who learned her skills from her mother-in-law, sister-in-law and other northern elders, is now sharing her knowledge through Nunavut's first midwifery training program.
"Before colonization", Kango said "there were no doctors or nurses in Nunavut, so men and women stepped forward to be midwives. But in the 1960s and '70s, when western medicine arrived full force, mothers had to leave their homes, husbands and children six to seven months before their delivery to give birth in distant hospitals".
"With this kind of method of hospitals to send the mother out without husband or parents to attend, it was hard for the mother," Kango said. "With increased stressed, they would smoke more, lose their appetite and lose interest in looking after themselves. Oftentimes, health professionals couldn't speak any Inuit languages, leaving the women isolated in pain".
Midwifery takes a northern look
More women choose do-it-yourself births - Pregnancy- msnbc.com
By Linda Carroll
msnbc.com contributor
updated 1:05 p.m. ET Dec. 6, 2009
"Jennifer Margulis thinks birth should be a private party — no doctors or midwives invited. So when her daughter Leone Francesca was born at home last month, only Margulis and her husband, James, were in attendance.
“My husband and I were the only ones there when she was conceived,” says the 40-year-old writer from Ashland, Ore. “I thought we should be the only ones there when she was born.”
Margulis is part of a very small but growing number of women who are choosing to deliver their babies at home without the presence of health professionals. Some choose to have a husband or another family member help, while others opt to deliver their babies completely on their own."
Jennifer Margulis, 40, of Ashland, Ore., gave birth to her daughter Leone Francesca at home Nov. 4 without medical or midwifery help.
I can understand why women would choose to birth on their own or with their loved ones in this modern climate around birth. These women are telling us in the health care industry that they are not happy with what we are doing. If we want to have a place at birth with intelligent, self aware women who understand the process and feel comfortable with their bodies then we have to pay attention to what they want.
I personally love it when I am redundant at birth. When the women are fully present and aware and confident. They manage their labours beautifully, they breathe their babies and their placentas out easily; they and their babies are well and healthy. When I've sat on my hands and enjoyed the process and the woman's sense of self mastery, that's my idea of a good days/nights' work.
Unattended births can be problematic, that's true. So can attended births. The issue, no matter where or with whom women chose to give birth, is how does the woman feel, what does she know, is she well nourished, does she love her partner and how is their relationship, how confident is she in herself and what else is going on?
For women in developing countries it is often a very different situation. The problems for birthing women in developing countries are multifactorial. These women are usually anaemic, have no birth control and therefore too many babies already, they are tired and poorly nourished. They usually work too hard and don't have any support of any kind. These women often don't have the stamina and energetic resources to stay mindful and present to the birthing process to keep safe.
Let's listen to women, find out what they want. Rather than seeking to undermine their confidence to get compliance with our agendas, let's listen and change what we are doing to be more likely to be invited to be part of the most amazing experience on earth.
More women choose do-it-yourself births - Pregnancy- msnbc.com
Saturday 19 December 2009
Ina May Awarded Honorary Doctorate « Ina May Gaskin
Ina May Awarded Honorary Doctorate « Ina May Gaskin
Ina May's blog tells us that:
"LONDON—Ina May Gaskin, of Summertown, Tennessee, was awarded the title “Honorary Doctor” by the Thames Valley University, London, England, on November 24, 2009. The award was presented by the faculty of the Health and Human Sciences division of the University in recognition of her work in demonstrating through midwifery and natural childbirth that women’s bodies still work as they were designed. Gaskin accepted the award in the Grand Auditorium of Wembley Stadium before an audience of 600.
I came across Spiritual Midwifery when it was released in the 70's. I can't remember how I found out about the book. But I do remember how much the book affected me and my practice. I adored the book and was radicalised by the ideas in it. I carried it everywhere. In the early 80's, I was working on night duty as the relief night manager in a maternity unit. I left the book on the labour ward desk when I did a 'round' of the wards. One of the older obstetricians, known for his difficult and pedantic manner, passed me with his nose deliberately 'up in the air' and said, glancing at me with a twinkle in his eyes "I'm off to do a spiritual caesarean!". I knew he'd been reading my book in the labour ward. I thought to myself that could only be a good thing.
I loved Ina May's gentle loving approach to women and birth. I loved the common sense, practical way she worked with women and incorporated men into the birthing process. Ina May has been the shining light for keeping birth normal and helping midwives to reclaim their place with women. The stories of the Farm midwives and the women's experiences of birth fueled my desire to work one on one with women. I credit Ina May with being a big reason why I finally took the plunge into private midwifery practice with Maralyn Fourer (ex Rowley), together gaining visiting rights in public hospitals at a time when midwives didn't do such a thing. Ina May's Guide to Childbirth is another classic and I find that women today really value this book for the calm, sensible, affirmative approach it takes.
Sincere congratulations to Ina May for her forward thinking, beautifully expressed, deeply held trust in women and their birthing process. You are a legend and you deserve this honour. Thanks for being my mentor (even though you don't know you were/are).
Ina May's blog tells us that:
"LONDON—Ina May Gaskin, of Summertown, Tennessee, was awarded the title “Honorary Doctor” by the Thames Valley University, London, England, on November 24, 2009. The award was presented by the faculty of the Health and Human Sciences division of the University in recognition of her work in demonstrating through midwifery and natural childbirth that women’s bodies still work as they were designed. Gaskin accepted the award in the Grand Auditorium of Wembley Stadium before an audience of 600.
Gaskin, who will turn 70 in March, thanked her mother for not scaring her about childbirth; Dr. Grantly Dick-Read (author of the classic Childbirth Without Fear); her high school biology teacher for teaching her to keep an open mind; her husband, Stephen Gaskin, for allowing 270 young people to accompany him on a lecture tour in the winter of 1970-71; and several physicians for mentoring her during the early years of her career as midwife.
Gaskin also thanked “the little Capuchin monkey who, in 1970, held my hand with an electrifying touch, thereby teaching me in an instant that I could also have touch that powerful if I lived as much in the moment as she did.”
I came across Spiritual Midwifery when it was released in the 70's. I can't remember how I found out about the book. But I do remember how much the book affected me and my practice. I adored the book and was radicalised by the ideas in it. I carried it everywhere. In the early 80's, I was working on night duty as the relief night manager in a maternity unit. I left the book on the labour ward desk when I did a 'round' of the wards. One of the older obstetricians, known for his difficult and pedantic manner, passed me with his nose deliberately 'up in the air' and said, glancing at me with a twinkle in his eyes "I'm off to do a spiritual caesarean!". I knew he'd been reading my book in the labour ward. I thought to myself that could only be a good thing.
I loved Ina May's gentle loving approach to women and birth. I loved the common sense, practical way she worked with women and incorporated men into the birthing process. Ina May has been the shining light for keeping birth normal and helping midwives to reclaim their place with women. The stories of the Farm midwives and the women's experiences of birth fueled my desire to work one on one with women. I credit Ina May with being a big reason why I finally took the plunge into private midwifery practice with Maralyn Fourer (ex Rowley), together gaining visiting rights in public hospitals at a time when midwives didn't do such a thing. Ina May's Guide to Childbirth is another classic and I find that women today really value this book for the calm, sensible, affirmative approach it takes.
Sincere congratulations to Ina May for her forward thinking, beautifully expressed, deeply held trust in women and their birthing process. You are a legend and you deserve this honour. Thanks for being my mentor (even though you don't know you were/are).
The Disappearing Male
Michael Mendezza from Touch the Future shared this information about the effect of environmental toxins on male fetuses and fertility. Artificial chemicals in the environment have increased from less than 100 in the early 1900's to over 86,000 now. The video below explains that 85% of those chemicals have not been evaluated for safety for human babies.
Michael encourages us to get informed. The following came from Michael's newsletter.
Download and read the complete interview with Peat Myers, Chief Executive Officer of Environmental Health Science, one who has been involved with the science behind this issue since it began. He describes with profound clarity how hormones bind with DNA which trigger protein expression - and how chemicals that mimic hormones, in this case estrogen, are altering human development around the world - it is excellent.
From the video site: "The Disappearing Male is a CBC documentary about one of the most important, and least publicized, issues facing the human species: the toxic threat to the male reproductive system. The last few decades have seen steady and dramatic increases in the incidence of boys and young men suffering from genital deformities, low sperm count, sperm abnormalities and testicular cancer. At the same time, boys are now far more at risk of suffering from ADHD, autism, Tourette's syndrome, cerebral palsy, and dyslexia. The Disappearing Male takes a close and disturbing look at what many doctors and researchers now suspect are responsible for many of these problems: a class of common chemicals that are ubiquitous in our world. Found in everything from shampoo, sunglasses, meat and dairy products, carpet, cosmetics and baby bottles, they are called "hormone mimicking" or "endocrine disrupting" chemicals and they may be starting to damage the most basic building blocks of human development". Bisphenol A is a synthetic oestrogen that affects cell differentiation in the fetus, having a particularly troublesome effect on male fetuses/babies.
What is Bisphenol A? Bisphenol A is a chemical commonly used in the manufacture of clear polycarbonate plastic. It is one of the top 50 products produced by the chemical industry, generating revenues in the order of $6 million per day in the United States, Europe, and Japan alone. Global bisphenol A production exceeds 6.4 billion pounds per year.
How pervasive is it? Most people reading this will have come into contact with bisphenol A at some stage in their life. A study by the United States Centers for Disease Control and Prevention found that 95% of Americans have detectable levels of bisphenol A in their bodies. Researchers also found that the median level of bisphenol A in humans was substantially higher than the level that causes adverse effects in other animals.
Where is it found? Bisphenol A is commonly found in a range of polycarbonate plastic products, including most plastic baby bottles. It is also found in the following:
What can we do? Given that bisphenol A has been found to alter cell behaviour even at very low levels – in the parts per trillion – the safest approach is to avoid using products containing it altogether. This is especially important during pregnancy and infancy.
Breastfeeding babies is best, the baby's mother however, needs to avoid bisphenol A containing products. If a mother is bottle feeding her baby, then ensuring the bottles and teats that are used are made of products that do not contain bisphenol A is important.
You may also like to watch a brief ABC report on Bisphenol A and newborn health.
References
vom Saal, F.S. and Welshons, W.V. Large effects from small exposures: II. The importance of positive controls in low-dose research on bisphenol A. Environmental Research, Online November, 2005. doi:10.1016/j.envres.2005.09.001.
vom Saal, F.S. and Hughes, C. An extensive new literature concerning low-dose effects of bisphenol A shows the need for a new risk assessment. Environ. Health Perspect. 113:926-933, 2005.
Gibson, R.L. Toxic Baby Bottles. Scientific Study finds leaching chemicals in clear plastic baby bottles. Environment California Research & Policy Center. Feb 2007
Michael encourages us to get informed. The following came from Michael's newsletter.
Download and read the complete interview with Peat Myers, Chief Executive Officer of Environmental Health Science, one who has been involved with the science behind this issue since it began. He describes with profound clarity how hormones bind with DNA which trigger protein expression - and how chemicals that mimic hormones, in this case estrogen, are altering human development around the world - it is excellent.
From the video site: "The Disappearing Male is a CBC documentary about one of the most important, and least publicized, issues facing the human species: the toxic threat to the male reproductive system. The last few decades have seen steady and dramatic increases in the incidence of boys and young men suffering from genital deformities, low sperm count, sperm abnormalities and testicular cancer. At the same time, boys are now far more at risk of suffering from ADHD, autism, Tourette's syndrome, cerebral palsy, and dyslexia. The Disappearing Male takes a close and disturbing look at what many doctors and researchers now suspect are responsible for many of these problems: a class of common chemicals that are ubiquitous in our world. Found in everything from shampoo, sunglasses, meat and dairy products, carpet, cosmetics and baby bottles, they are called "hormone mimicking" or "endocrine disrupting" chemicals and they may be starting to damage the most basic building blocks of human development". Bisphenol A is a synthetic oestrogen that affects cell differentiation in the fetus, having a particularly troublesome effect on male fetuses/babies.
What is Bisphenol A? Bisphenol A is a chemical commonly used in the manufacture of clear polycarbonate plastic. It is one of the top 50 products produced by the chemical industry, generating revenues in the order of $6 million per day in the United States, Europe, and Japan alone. Global bisphenol A production exceeds 6.4 billion pounds per year.
How pervasive is it? Most people reading this will have come into contact with bisphenol A at some stage in their life. A study by the United States Centers for Disease Control and Prevention found that 95% of Americans have detectable levels of bisphenol A in their bodies. Researchers also found that the median level of bisphenol A in humans was substantially higher than the level that causes adverse effects in other animals.
Where is it found? Bisphenol A is commonly found in a range of polycarbonate plastic products, including most plastic baby bottles. It is also found in the following:
- children’s toys
- dental sealants
- epoxy lining of food and beverage cans
- reusable drink containers
- microwavable food containers
- electronic equipment
- sports helmets
- eyeglass lenses
What can we do? Given that bisphenol A has been found to alter cell behaviour even at very low levels – in the parts per trillion – the safest approach is to avoid using products containing it altogether. This is especially important during pregnancy and infancy.
Breastfeeding babies is best, the baby's mother however, needs to avoid bisphenol A containing products. If a mother is bottle feeding her baby, then ensuring the bottles and teats that are used are made of products that do not contain bisphenol A is important.
You may also like to watch a brief ABC report on Bisphenol A and newborn health.
References
vom Saal, F.S. and Welshons, W.V. Large effects from small exposures: II. The importance of positive controls in low-dose research on bisphenol A. Environmental Research, Online November, 2005. doi:10.1016/j.envres.2005.09.001.
vom Saal, F.S. and Hughes, C. An extensive new literature concerning low-dose effects of bisphenol A shows the need for a new risk assessment. Environ. Health Perspect. 113:926-933, 2005.
Gibson, R.L. Toxic Baby Bottles. Scientific Study finds leaching chemicals in clear plastic baby bottles. Environment California Research & Policy Center. Feb 2007
Want to live well? Harvard experts offer pragmatic pointers on getting healthy and staying there
"The long-running Nurses’ Health Study shows that as much as 80 percent of heart disease, 70 percent of strokes, and 90 percent of diabetes — three of the nation’s top 10 killers — are related to just four lifestyle factors: avoiding smoking, maintaining a healthy weight, exercising regularly, and embracing a heart-healthy diet.
“They are absolutely astonishing numbers,” said Manson, who is beginning a large trial of vitamin D’s role in preventing illness. “Studies demonstrate the powerful role of lifestyle factors in preventing chronic disease. One of the most important prescriptions doctors can write is to prescribe regular physical activity.”
One area where knowledge has advanced rapidly in recent years involves the importance of maintaining a healthy body weight, which Willett said is understood much better today than even a decade ago and is linked to heart disease, diabetes, and many cancers".
Other aspects to what constitutes a healthy and rewarding life are explored in this article.
Getting enough quality sleep, saving money, being kind, taking time to reflect and be still to name a few.
The article continues:
"Though people make individual decisions that affect their well-being every day, people are at their core social animals. Recent research has detected those social underpinnings in their personal behavior.
Nicholas Christakis, professor of medical sociology at Harvard Medical School and Beth Israel Deaconess Medical Center, explores the effects of social networks on health. His research indicates that everything from obesity to smoking to happiness to loneliness can spread through social networks.
Still, Christakis cautioned that someone looking to live healthier should not just avoid friends who have unhealthy habits. Social networks are important, providing companionship and support even from those who smoke or eat junk food. There’s far more to gain, he said, in lending a hand to struggling friends than there is from cutting them off."
Want to live well? Harvard experts offer pragmatic pointers on getting healthy and staying there
“They are absolutely astonishing numbers,” said Manson, who is beginning a large trial of vitamin D’s role in preventing illness. “Studies demonstrate the powerful role of lifestyle factors in preventing chronic disease. One of the most important prescriptions doctors can write is to prescribe regular physical activity.”
One area where knowledge has advanced rapidly in recent years involves the importance of maintaining a healthy body weight, which Willett said is understood much better today than even a decade ago and is linked to heart disease, diabetes, and many cancers".
Other aspects to what constitutes a healthy and rewarding life are explored in this article.
Getting enough quality sleep, saving money, being kind, taking time to reflect and be still to name a few.
The article continues:
"Though people make individual decisions that affect their well-being every day, people are at their core social animals. Recent research has detected those social underpinnings in their personal behavior.
Nicholas Christakis, professor of medical sociology at Harvard Medical School and Beth Israel Deaconess Medical Center, explores the effects of social networks on health. His research indicates that everything from obesity to smoking to happiness to loneliness can spread through social networks.
Still, Christakis cautioned that someone looking to live healthier should not just avoid friends who have unhealthy habits. Social networks are important, providing companionship and support even from those who smoke or eat junk food. There’s far more to gain, he said, in lending a hand to struggling friends than there is from cutting them off."
Want to live well? Harvard experts offer pragmatic pointers on getting healthy and staying there
Obstetricians' peer pressure: the problems with one sided mandated collaboration
Dr Jenny Gamble, President of the Australian College of Midwives, in her appearance before the Senate Committee on Thursday, 18th December 2009, explained how her private midwifery practice changed overnight because doctors changed their mind about 'collaboration'.
"About 15 months into the arrangement the three obstetricians, whom we had written agreements with, pulled out within the space of 10 days. We lost our livelihood. All of the women on our books—and there were a significant number; they were providing the livelihood of four midwives—who were still in pregnancy and still had their pregnancy, labour, birth and postpartum care to go with us, were now left without the option of continuing care with us and having a hospital birth. Effectively, we were forced into a home birth practice
In fact, the state government had to step in at that stage to make interim arrangements for the
remaining women on our books so that they could continue under our care and have a hospital birth, after much ado—minister visitors, lobbying, submissions. So we were on thin ice—‘Yes, I’ll have a collaborative arrangement with you; oops! No. I’ve changed my mind.’
We did not have any mishaps. We did not have a postpartum haemorrhage. We did not have a baby admitted to a special care nursery. Nobody died. In fact, we have had outcomes from our practice which are world’s best—a seven per cent caesarean section rate, with no postpartum complications and no re-admissions to hospital. We had excellent outcomes and they all pulled out within the space of 10 days—and I always thought it was because they had no-one to sit next to at the Christmas dinner! They had a lot of pressure from their peers not to do it."
Jenny continued, explaining how the proposed bills before the Senate would impact midwifery practice.
"Under this arrangement, you will not be forced into a home birth practice; you will be forced out of
practice".
Obviously women's choice of caregiver and place of birth will also be severely curtailed by this legislation.
People point to the fact that Belmont Birthing Service has excellent collaborative agreements, based on the Australian College of Midwives Guidelines for Consultation and Referral.
Thanks to Dr Andrew Bisits, the champion of choice, that's true. But what would happen if Andrew were to retire, or move elsewhere? Who would take up the challenge to support the practice?
Would the situation have the same outcome for Belmont as it did for Jenny's service when the obstetricians changed their mind? If there was no obstetrician prepared to state categorically that he/she would take over from Andrew Bisits, would the health service continue to provide that option for women? Worth noting that up the valley, within the same health service, opposition from local GP's means there is no comparable midwifery based service for the women in the area, despite there being local midwives who would like to practice in a continuity of care service and women who lobby to have that care.
Dr Jenny Gamble explains the issues with the proposed amendments to the bills and the idea of mandating a 'collaborative' relationship for midwives only:
"Collaboration is a very important thing in health care and we know that you know that. We also buy in completely to the idea of collaboration and I know my colleagues will talk about how that is already embedded in regulatory frameworks, registration and clinical governance of midwives. At every level we accept collaboration as a concept. When you collaborate with people when one party must and the other party may and there might be reasons that the person who may collaborate does not want to, you do not have collaboration and that is the fundamental problem with all of this. Just because some medical practitioners may, do and will collaborate does not actually make for collaboration and to legislate that you have a signed written agreement with a medical practitioner becomes meaningless and unworkable.
Perhaps we have heard examples today of where the medical practitioner may choose not to collaborate with the midwife in relation to homebirth but in fact from the college’s point of view, we can think of thousands of clinical examples where the woman may make choices that the doctor does not think are in her best interests.
The midwife wants to respect the woman’s right to self-determination, give her information and ensure she is fully informed but also respect her right to make the decision, even if it is a decision the midwife disagrees with—and then she will not be able to find a collaborating doctor to help care for that woman, because the doctor will choose not to participate in care that the doctor does not think is in the woman’s best interests. So right away we have this funny relationship: ‘I’ll decide what’s in your best interests and that’s the sort of care I’ll support.’
We are not talking about surgery here; we are talking about having a baby, a normal physiological process for many women with vulnerabilities and risks that might need referral to medical care.
To legislate that one party has to have a collaborative arrangement with another party to practise is
problematic. What we are unclear about, and what has not been able to be cleared up for us, is how far this goes in restricting midwives. If you cannot get a collaborative arrangement with a medical practitioner, does that mean you cannot practise? Does it mean you cannot get access to MBS? Or do they put it in the professional indemnity insurance product that you have to be eligible or have to have a collaborative arrangement to access professional indemnity insurance? And you cannot even get professional indemnity insurance, and you cannot even register. All of that is completely unclear. With all these things being unclear and those questions being unable to be answered by any of the bureaucrats that we have spoken to, it seems to me that to put it in the legislation is a highly flawed position. There are a number of other mechanisms to ensure collaboration. The college, our members, midwives generally and doctors generally all agree collaboration is a good idea.
It is a benevolent patriarchy when the doctor can decide with whom and when they will collaborate.
It is not freedom if your freedom is granted by others. (emphasis my addition)
The problems associated with having a group of professionals 'in charge', especially when those professionals can have widely differing viewpoints and practices, means that those who have to work with (read 'under') those professionals are vulnerable to the whims of those they work with.
In the case of midwives and obstetricians, collaboration works well when you have strong, open minded, women friendly, birth comfortable obstetricians together with health services which put women at the centre of concern. When health services put women at the centre of concern, the work of both midwives and obstetricians is equally valued and neither group is preferenced above another. Of course, when health services are more driven by the culture associated with 'professional silos', then the individual woman and birth friendly obstetrician is under incredible pressure to conform to the 'norm'. As in Jenny Gamble's example, such pressure is difficult to endure without succumbing.
However, those women centred health services and woman and birth friendly obstetricians are few and far between. If obstetricians perception of their 'right to rule' is strengthened by legislation, then support for optimising women's natural processes and midwives ways of working are doomed.
"About 15 months into the arrangement the three obstetricians, whom we had written agreements with, pulled out within the space of 10 days. We lost our livelihood. All of the women on our books—and there were a significant number; they were providing the livelihood of four midwives—who were still in pregnancy and still had their pregnancy, labour, birth and postpartum care to go with us, were now left without the option of continuing care with us and having a hospital birth. Effectively, we were forced into a home birth practice
In fact, the state government had to step in at that stage to make interim arrangements for the
remaining women on our books so that they could continue under our care and have a hospital birth, after much ado—minister visitors, lobbying, submissions. So we were on thin ice—‘Yes, I’ll have a collaborative arrangement with you; oops! No. I’ve changed my mind.’
We did not have any mishaps. We did not have a postpartum haemorrhage. We did not have a baby admitted to a special care nursery. Nobody died. In fact, we have had outcomes from our practice which are world’s best—a seven per cent caesarean section rate, with no postpartum complications and no re-admissions to hospital. We had excellent outcomes and they all pulled out within the space of 10 days—and I always thought it was because they had no-one to sit next to at the Christmas dinner! They had a lot of pressure from their peers not to do it."
Jenny continued, explaining how the proposed bills before the Senate would impact midwifery practice.
"Under this arrangement, you will not be forced into a home birth practice; you will be forced out of
practice".
Obviously women's choice of caregiver and place of birth will also be severely curtailed by this legislation.
People point to the fact that Belmont Birthing Service has excellent collaborative agreements, based on the Australian College of Midwives Guidelines for Consultation and Referral.
Thanks to Dr Andrew Bisits, the champion of choice, that's true. But what would happen if Andrew were to retire, or move elsewhere? Who would take up the challenge to support the practice?
Would the situation have the same outcome for Belmont as it did for Jenny's service when the obstetricians changed their mind? If there was no obstetrician prepared to state categorically that he/she would take over from Andrew Bisits, would the health service continue to provide that option for women? Worth noting that up the valley, within the same health service, opposition from local GP's means there is no comparable midwifery based service for the women in the area, despite there being local midwives who would like to practice in a continuity of care service and women who lobby to have that care.
Dr Jenny Gamble explains the issues with the proposed amendments to the bills and the idea of mandating a 'collaborative' relationship for midwives only:
"Collaboration is a very important thing in health care and we know that you know that. We also buy in completely to the idea of collaboration and I know my colleagues will talk about how that is already embedded in regulatory frameworks, registration and clinical governance of midwives. At every level we accept collaboration as a concept. When you collaborate with people when one party must and the other party may and there might be reasons that the person who may collaborate does not want to, you do not have collaboration and that is the fundamental problem with all of this. Just because some medical practitioners may, do and will collaborate does not actually make for collaboration and to legislate that you have a signed written agreement with a medical practitioner becomes meaningless and unworkable.
Perhaps we have heard examples today of where the medical practitioner may choose not to collaborate with the midwife in relation to homebirth but in fact from the college’s point of view, we can think of thousands of clinical examples where the woman may make choices that the doctor does not think are in her best interests.
The midwife wants to respect the woman’s right to self-determination, give her information and ensure she is fully informed but also respect her right to make the decision, even if it is a decision the midwife disagrees with—and then she will not be able to find a collaborating doctor to help care for that woman, because the doctor will choose not to participate in care that the doctor does not think is in the woman’s best interests. So right away we have this funny relationship: ‘I’ll decide what’s in your best interests and that’s the sort of care I’ll support.’
We are not talking about surgery here; we are talking about having a baby, a normal physiological process for many women with vulnerabilities and risks that might need referral to medical care.
To legislate that one party has to have a collaborative arrangement with another party to practise is
problematic. What we are unclear about, and what has not been able to be cleared up for us, is how far this goes in restricting midwives. If you cannot get a collaborative arrangement with a medical practitioner, does that mean you cannot practise? Does it mean you cannot get access to MBS? Or do they put it in the professional indemnity insurance product that you have to be eligible or have to have a collaborative arrangement to access professional indemnity insurance? And you cannot even get professional indemnity insurance, and you cannot even register. All of that is completely unclear. With all these things being unclear and those questions being unable to be answered by any of the bureaucrats that we have spoken to, it seems to me that to put it in the legislation is a highly flawed position. There are a number of other mechanisms to ensure collaboration. The college, our members, midwives generally and doctors generally all agree collaboration is a good idea.
It is a benevolent patriarchy when the doctor can decide with whom and when they will collaborate.
It is not freedom if your freedom is granted by others. (emphasis my addition)
The problems associated with having a group of professionals 'in charge', especially when those professionals can have widely differing viewpoints and practices, means that those who have to work with (read 'under') those professionals are vulnerable to the whims of those they work with.
In the case of midwives and obstetricians, collaboration works well when you have strong, open minded, women friendly, birth comfortable obstetricians together with health services which put women at the centre of concern. When health services put women at the centre of concern, the work of both midwives and obstetricians is equally valued and neither group is preferenced above another. Of course, when health services are more driven by the culture associated with 'professional silos', then the individual woman and birth friendly obstetrician is under incredible pressure to conform to the 'norm'. As in Jenny Gamble's example, such pressure is difficult to endure without succumbing.
However, those women centred health services and woman and birth friendly obstetricians are few and far between. If obstetricians perception of their 'right to rule' is strengthened by legislation, then support for optimising women's natural processes and midwives ways of working are doomed.
Collaboration: Doctors don't want to be like ambulances at the bottom of the cliff: waiting for disasters
COMMONWEALTH OF AUSTRALIA
CONDITIONS OF DISTRIBUTION
This is an uncorrected proof of evidence taken before the committee.
It is made available under the condition that it is recognised
as such.
BY AUTHORITY OF THE SENATE
[PROOF COPY]
TO EXPEDITE DELIVERY, THIS TRANSCRIPT HAS NOT BEEN SUBEDITED
Dr Weaver—The other message we got in forming our submission for the Maternity Services Review was that doctors did not want to have a woman brought into hospital with all sorts of problems when they had had no opportunity to be involved in her care and then have to make quick decisions. The woman would have the perception that everything was going all right until they saw the doctor. There was no opportunity to be involved in care early. In other words, they do not want to be seen, as somebody said, as the ambulance at the bottom of the cliff. They wanted and needed to have that involvement, to be able to have a discussion with the woman, in the event that problems arose during her labour, as they do. The clear message we got from the fellowship of the college was that they did not want to have to pick up the pieces at the end of something.
CHAIR—That being their only role?
Dr Weaver—That being their only role. Again, most of them acknowledged that they worked in good
systems of care and they valued and respected their midwifery colleagues and were happy to work with them,but as I said, the clear message was that they did not want to have to pick up the pieces from so-called independent midwives.
CHAIR—The term ‘collaboration’ seems to be agreed by everyone. In the absence of the detail of what that means, people are able to put their worst-case fears of what that could mean as opposed to what it will mean and that gets into that circular process. I think that the fact that the amendments were put out before people had a sense of what that could mean has in some ways created an even greater difference. Certainly the evidence today from the various midwives groups and consumer groups was as I said: they put forward cases where they had to date had no effective collaboration and had in effect been stopped from doing what they wanted to do by various parts of the system—and it varied. They felt that collaboration that was dependent upon having that approval, which up until now has not been there, could mean that they would not be able to continue to operate.
The consumers were saying that it should be ‘consumer informed consent’—that was the term that was consistently used. The idea is that the consumer, having clear information from all of the people involved in providing the service, can then have their role clarified and codified in that process. Have I missed anything in that process?
The comments by Dr Ted Weaver are illuminating in that they strike at one of the basic problems threaded throughout this long 'turf war' history of midwives, women and medical men/women.
The idea of doctors waiting for disasters to happen in maternity care indicates their problem based medical training. Their training is problem based because doctors are about curing and alleviating sickness and injury. Emergency doctors work in emergency departments to take care of people who come in following accidents or illnesses which occur during/as a result of engaging in their activities of daily living. Emergency doctors don't want to get to know bike riders, tennis players, skiers, swimmers or drivers before they have an accident or before they do what it is they are doing in their lives as they are living them.
The problem with problem based training is that doctors are trained for problems. That is how it should be when there are problems to deal with. However, when the subject under scrutiny is a normal healthy process that is different as fingerprints for every woman who undergoes it and even for the same woman in different pregnancies, that uniqueness and variability creates a problem for the problem minded.
Healing is a natural healthy process. Healing occurs because something has been damaged as a result of some insult or other.
However childbirth is a natural healthy process and is generally the result of loving, fun activity, not some insult or other (although occasionally and tragically, pregnancy can result from rape).
Healing can be aided and propelled by drugs or surgery.
Childbearing however, is helped most by loving, encouraging companionship.
Drugs and surgery are doctors realm. Loving, encouraging companionship is a midwife's realm.
Childbearing would be better conceptualised as a form of extreme 'sport' than an illness model of human activity. Women's bodies are perfectly suited to give birth, just like people's bodies are perfectly suited to become runners, skiers or long jumpers etc. Preparation, understanding, practice and supportive encouragement are needed to ensure their bodies' function optimally.
Therefore obstetric doctors 'waiting' for disasters is appropriate. Emergency doctors wait for broken ankles etc. Obstetricians are more sensibly employed 'waiting' for women who need intervention, rather than imposing intervention on normal healthy processes that are expressed individually. Ted Weaver's throw away phrase 'as they do' at the end of his statement of waiting for problems to occur in labour, is a powerful indicator of the way that a practitioner's failure to appreciate diversity in the way that human birth is expressed, coupled with an expectation of problems leads to actions, like interventions, to speed things up etc creating the very problems they are worried about.
Interestingly, when women are given the kind of care that informs, supports and encourages them through their experience of childbearing, as the statistics demonstrate, heroic 'rescues' are very few and far between. As Jenny Gamble's practice statistics, our Newcastle private practice statistics and the Belmont Birthing Service Statistics show (plus many overseas examples), women and babies are safe and mothers are more satisfied with their experiences when they are provided with one to one midwifery care.
Proof Committee Hansard
SENATE
COMMUNITY AFFAIRS LEGISLATION COMMITTEE
Reference: Health Legislation Amendment (Midwives and Nurse Practitioners) Bill
2009; Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill
2009; Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009
THURSDAY, 17 DECEMBER 2009
CANBERRA
SENATE
COMMUNITY AFFAIRS LEGISLATION COMMITTEE
Reference: Health Legislation Amendment (Midwives and Nurse Practitioners) Bill
2009; Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill
2009; Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009
THURSDAY, 17 DECEMBER 2009
CANBERRA
CONDITIONS OF DISTRIBUTION
This is an uncorrected proof of evidence taken before the committee.
It is made available under the condition that it is recognised
as such.
BY AUTHORITY OF THE SENATE
[PROOF COPY]
TO EXPEDITE DELIVERY, THIS TRANSCRIPT HAS NOT BEEN SUBEDITED
Dr Weaver—The other message we got in forming our submission for the Maternity Services Review was that doctors did not want to have a woman brought into hospital with all sorts of problems when they had had no opportunity to be involved in her care and then have to make quick decisions. The woman would have the perception that everything was going all right until they saw the doctor. There was no opportunity to be involved in care early. In other words, they do not want to be seen, as somebody said, as the ambulance at the bottom of the cliff. They wanted and needed to have that involvement, to be able to have a discussion with the woman, in the event that problems arose during her labour, as they do. The clear message we got from the fellowship of the college was that they did not want to have to pick up the pieces at the end of something.
CHAIR—That being their only role?
Dr Weaver—That being their only role. Again, most of them acknowledged that they worked in good
systems of care and they valued and respected their midwifery colleagues and were happy to work with them,but as I said, the clear message was that they did not want to have to pick up the pieces from so-called independent midwives.
CHAIR—The term ‘collaboration’ seems to be agreed by everyone. In the absence of the detail of what that means, people are able to put their worst-case fears of what that could mean as opposed to what it will mean and that gets into that circular process. I think that the fact that the amendments were put out before people had a sense of what that could mean has in some ways created an even greater difference. Certainly the evidence today from the various midwives groups and consumer groups was as I said: they put forward cases where they had to date had no effective collaboration and had in effect been stopped from doing what they wanted to do by various parts of the system—and it varied. They felt that collaboration that was dependent upon having that approval, which up until now has not been there, could mean that they would not be able to continue to operate.
The consumers were saying that it should be ‘consumer informed consent’—that was the term that was consistently used. The idea is that the consumer, having clear information from all of the people involved in providing the service, can then have their role clarified and codified in that process. Have I missed anything in that process?
The comments by Dr Ted Weaver are illuminating in that they strike at one of the basic problems threaded throughout this long 'turf war' history of midwives, women and medical men/women.
The idea of doctors waiting for disasters to happen in maternity care indicates their problem based medical training. Their training is problem based because doctors are about curing and alleviating sickness and injury. Emergency doctors work in emergency departments to take care of people who come in following accidents or illnesses which occur during/as a result of engaging in their activities of daily living. Emergency doctors don't want to get to know bike riders, tennis players, skiers, swimmers or drivers before they have an accident or before they do what it is they are doing in their lives as they are living them.
The problem with problem based training is that doctors are trained for problems. That is how it should be when there are problems to deal with. However, when the subject under scrutiny is a normal healthy process that is different as fingerprints for every woman who undergoes it and even for the same woman in different pregnancies, that uniqueness and variability creates a problem for the problem minded.
Healing is a natural healthy process. Healing occurs because something has been damaged as a result of some insult or other.
However childbirth is a natural healthy process and is generally the result of loving, fun activity, not some insult or other (although occasionally and tragically, pregnancy can result from rape).
Healing can be aided and propelled by drugs or surgery.
Childbearing however, is helped most by loving, encouraging companionship.
Drugs and surgery are doctors realm. Loving, encouraging companionship is a midwife's realm.
Childbearing would be better conceptualised as a form of extreme 'sport' than an illness model of human activity. Women's bodies are perfectly suited to give birth, just like people's bodies are perfectly suited to become runners, skiers or long jumpers etc. Preparation, understanding, practice and supportive encouragement are needed to ensure their bodies' function optimally.
Therefore obstetric doctors 'waiting' for disasters is appropriate. Emergency doctors wait for broken ankles etc. Obstetricians are more sensibly employed 'waiting' for women who need intervention, rather than imposing intervention on normal healthy processes that are expressed individually. Ted Weaver's throw away phrase 'as they do' at the end of his statement of waiting for problems to occur in labour, is a powerful indicator of the way that a practitioner's failure to appreciate diversity in the way that human birth is expressed, coupled with an expectation of problems leads to actions, like interventions, to speed things up etc creating the very problems they are worried about.
Interestingly, when women are given the kind of care that informs, supports and encourages them through their experience of childbearing, as the statistics demonstrate, heroic 'rescues' are very few and far between. As Jenny Gamble's practice statistics, our Newcastle private practice statistics and the Belmont Birthing Service Statistics show (plus many overseas examples), women and babies are safe and mothers are more satisfied with their experiences when they are provided with one to one midwifery care.
Friday 18 December 2009
Consensus, collaboration and power imbalances - words from the Senate Hearing on Women's choice of birthplace and midwife's role
From the Senate hearing
Senator SIEWERT—The issue around consensus is about somebody who has spent years of her life in a
consensus system—a consensus decision-making process. One of the things I clearly know is that, if there is a power imbalance, consensus tends not to work, because at the end of the day the people holding the power can say, ‘I don’t care what you think; we’re the ones that sign on the dotted line at the end of this process.’ That seems to me to be one of the keys here. You can say that the medical practitioners will collaborate and want a consensus approach, but at the end of the day it is the medical profession and obstetricians who will be responsible for signing off on collaborative care arrangements under the current process, and that is what
people are concerned about. It seems to me that it is clear that there is a power imbalance when you are happy with this amendment but patients, midwives and nurse practitioners are not happy with it. So that says to me that fundamentally there is an issue here.
Dr Pesce—All right. We have lots of very happy patients that do not seem to be unhappy with the power
balance. But in trying to address—
Senator SIEWERT—We have 2,000 emails from people saying that they do not like the current
amendment.
Dr Pesce—And there are 280,000 births a year. But we do not have to get stuck on that. In terms of the
power imbalance, if there is a power imbalance, I suspect that it emerges from the fact that we have different
competencies and that, at the end of the day, when something goes wrong—in an abnormal or high-risk
pregnancy—it is an obstetrician that is required to perform an instrumental delivery or a caesarean section,
which is not within the competency of a midwife. If there is an imbalance, I suspect that it emerges from the
fact that midwives can care for a patient to a certain point and then, if something goes beyond that, they need
to enlist the services of a collaborating obstetrician. But that obstetrician obviously is hesitant to just become a
technician and say, ‘I will just step in when I am asked to.’ They would like to step in at the right time. So, if
there is a power imbalance, it arises from the different competencies of the people who work in the team,
Senator SIEWERT—The issue around consensus is about somebody who has spent years of her life in a
consensus system—a consensus decision-making process. One of the things I clearly know is that, if there is a power imbalance, consensus tends not to work, because at the end of the day the people holding the power can say, ‘I don’t care what you think; we’re the ones that sign on the dotted line at the end of this process.’ That seems to me to be one of the keys here. You can say that the medical practitioners will collaborate and want a consensus approach, but at the end of the day it is the medical profession and obstetricians who will be responsible for signing off on collaborative care arrangements under the current process, and that is what
people are concerned about. It seems to me that it is clear that there is a power imbalance when you are happy with this amendment but patients, midwives and nurse practitioners are not happy with it. So that says to me that fundamentally there is an issue here.
Dr Pesce—All right. We have lots of very happy patients that do not seem to be unhappy with the power
balance. But in trying to address—
Senator SIEWERT—We have 2,000 emails from people saying that they do not like the current
amendment.
Dr Pesce—And there are 280,000 births a year. But we do not have to get stuck on that. In terms of the
power imbalance, if there is a power imbalance, I suspect that it emerges from the fact that we have different
competencies and that, at the end of the day, when something goes wrong—in an abnormal or high-risk
pregnancy—it is an obstetrician that is required to perform an instrumental delivery or a caesarean section,
which is not within the competency of a midwife. If there is an imbalance, I suspect that it emerges from the
fact that midwives can care for a patient to a certain point and then, if something goes beyond that, they need
to enlist the services of a collaborating obstetrician. But that obstetrician obviously is hesitant to just become a
technician and say, ‘I will just step in when I am asked to.’ They would like to step in at the right time. So, if
there is a power imbalance, it arises from the different competencies of the people who work in the team,
Community Affairs Legislation S12666.pdf (application/pdf Object)
Proof Committee Hansard
SENATE
COMMUNITY AFFAIRS LEGISLATION COMMITTEE
Reference: Health Legislation Amendment (Midwives and Nurse Practitioners) Bill
2009; Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill
2009; Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009
THURSDAY, 17 DECEMBER 2009
CANBERRA
CONDITIONS OF DISTRIBUTION
This is an uncorrected proof of evidence taken before the committee.
It is made available under the condition that it is recognised
as such.
BY AUTHORITY OF THE SENATE
[PROOF COPY]
TO EXPEDITE DELIVERY, THIS TRANSCRIPT HAS NOT BEEN SUBEDITED
Great work by everyone at the Senate Committee hearing yesterday! Rachel Siewart (Green's senator) asked insightful questions.
Some comments below, from members of Maternity Coalition around the subject of safety - dynamic Dr 3am's catchcry - where was he when The Butcher of Bega was out and about?
"Mrs McIntosh —The way we see it is that the woman should be at the centre of that—her choices be
respected; all the information given; and safety looked at, not only physical safety for her and the baby but
also emotional and psychological safety. They are paramount not only to a woman’s experience through
pregnancy, labour and birth but also to breastfeeding, postnatal depression, relationships, bonding and ongoing
issues with siblings. They are all so intertwined that, if a woman is not right at the centre of the collaboration,
it is probably not going to be all that effective.
Ms Catchlove—Nobody has more interest in the safety of a baby than the mother of that baby. I make a
decision for my baby and myself, and I am absolutely 100 per cent motivated by safety. And I am the only
person who can weigh up what is a safe choice for me and my family.
Mr Teakle—Safety is about being comfortable with the risks. There is no way of defining something as
being safe or unsafe. We have a bunch of different people here who are going to have different feelings about
what risks they are comfortable with. Some doctors might be comfortable with the risks of a caesarean,
because that is something they are familiar with and they feel in control of it; a midwife might feel
comfortable with something else. Once we get into an argument about other people deciding what is safe for
the woman, then we have lost focus. The woman needs to decide what she feels safe with, on the advice that is
provided to her by experts who can give her really good advice about that. That is why in other countries
informed choice has been understood as the way of getting out of these arguments.
It is terrible to have arguments going on in the media about what choices women should make. That is not
about safety; that is about control".
S12666.pdf (application/pdf Object)
Gary Craig said: My Retirement…and a Gift to the EFT Community - EFT Blog
The wonderful Gary Craig is retiring. What a legend this humble, sensitive, gorgeous and generous man is!
EFT (Emotional Freedom Technique) is the most stunningly simple and effective tool for emotional management I have ever found.
I love it and am deeply grateful to Gary Craig for developing and sharing so generously this amazing technique.
Gary Craig said: My Retirement…and a Gift to the EFT Community - EFT Blog
EFT (Emotional Freedom Technique) is the most stunningly simple and effective tool for emotional management I have ever found.
I love it and am deeply grateful to Gary Craig for developing and sharing so generously this amazing technique.
Gary Craig said: My Retirement…and a Gift to the EFT Community - EFT Blog
What is "Normal"? - Mamapedia™ Voices
This is a lovely exploration of the concept of 'normal' by Lisa Morguess of "Finnian's Journey" on Mamapedia.
Good to ponder
A friend of mine had a baby with Down's syndrome.
She told me one day that her child 'wears his imperfections on the outside'.
What is "Normal"? - Mamapedia™ Voices
Good to ponder
A friend of mine had a baby with Down's syndrome.
She told me one day that her child 'wears his imperfections on the outside'.
What is "Normal"? - Mamapedia™ Voices
Ex-Bega doctor faces 52 more charges
From the Sydney Morning Herald Newspaper, Australia
"Former doctor Graeme Reeves appeared in court today, facing 52 more charges in regard to sexual assault, bodily harm and fraud offences. The new charges, which involve as many as 21 incidents, date back to 1989.
The previous set of more of than 100 charges Mr Reeves faces were all related to offences allegedly committed between 2001 and 2003.
Mr Reeves's bail was continued during a brief appearance at Parramatta Local Court just after midday"
Nine officers from Strike Force Tarella sat in the court, across the room from Mr Reeves, who sat quietly.
Also tendered in court today was a 180-page fact sheet relating to the new charges.
Included among the new allegations were 17 fraud charges.
"These fraud allegations basically flow from an allegation that he was not entitled to practise as an obstetrician,” Mr Murray told magistrate Vivian Swain. (my emphasis)
Known as the Butcher of Bega, "Mr Reeves, 59, is already charged with nine counts of aggravated sexual assault, six of indecent assault, one of genital mutilation and one of maliciously inflicting grievous bodily harm. The charges relate to 10 women on whom he operated between 2001 and 2003 while working at Bega on the NSW South Coast and in Richmond, in Sydney's north-west.
He has waived his right to a committal hearing and has yet to make a formal plea.
Strike Force Tarella has been investigating allegations of sexual assault, medical misconduct and genital mutilation involving Mr Reeves since it was formed in February 2008".
What else don't we know about those who argue against midwifery care and seek to limit women's choices about who they choose to birth with and where they have their babies? Who are these expert doctors who fight against women being given support by highly skilled and talented midwives, like Maggie, who provide excellent midwifery care throughout the childbearing period; care that is respectful, individual, one to one and valued by women and their families.
I wonder what dynamic doctor 3am thinks about this?
Ex-Bega doctor faces 52 more charges
DYLAN WELCH
December 15, 2009The previous set of more of than 100 charges Mr Reeves faces were all related to offences allegedly committed between 2001 and 2003.
Mr Reeves's bail was continued during a brief appearance at Parramatta Local Court just after midday"
Nine officers from Strike Force Tarella sat in the court, across the room from Mr Reeves, who sat quietly.
Also tendered in court today was a 180-page fact sheet relating to the new charges.
Included among the new allegations were 17 fraud charges.
"These fraud allegations basically flow from an allegation that he was not entitled to practise as an obstetrician,” Mr Murray told magistrate Vivian Swain. (my emphasis)
Known as the Butcher of Bega, "Mr Reeves, 59, is already charged with nine counts of aggravated sexual assault, six of indecent assault, one of genital mutilation and one of maliciously inflicting grievous bodily harm. The charges relate to 10 women on whom he operated between 2001 and 2003 while working at Bega on the NSW South Coast and in Richmond, in Sydney's north-west.
He has waived his right to a committal hearing and has yet to make a formal plea.
Strike Force Tarella has been investigating allegations of sexual assault, medical misconduct and genital mutilation involving Mr Reeves since it was formed in February 2008".
Midwife Maggie-Lecky Thompson, supported thousands of women and their families to birth their babies safely at home. Maggie was de-registered in 1998 largely on the testimony of the now notorious Dr. Reeves, the Butcher of Bega.
What else don't we know about those who argue against midwifery care and seek to limit women's choices about who they choose to birth with and where they have their babies? Who are these expert doctors who fight against women being given support by highly skilled and talented midwives, like Maggie, who provide excellent midwifery care throughout the childbearing period; care that is respectful, individual, one to one and valued by women and their families.
As Kelly from BellyBelly forum says "Isn't it amazing that even with his rap sheet, there's still no justice for a homebirth midwife who supported thousands of families to have safe homebirths".
I wonder what dynamic doctor 3am thinks about this?
Ex-Bega doctor faces 52 more charges
Mom fights, gets the delivery she wants - CNN.com
"(CNN) -- Seven months into her pregnancy with her fourth child, Joy Szabo's obstetrician gave her some news she didn't want to hear: Because she'd had a previous Caesarean section, the hospital where she planned to deliver was insisting she have another one.
Szabo wanted a vaginal delivery, and argued with hospital executives, but they stood firm: They refused to do vaginal births after Caesareans (VBACs) because they have a slightly higher risk for complications.After they lost that fight, Szabo and her husband, Jeff, made an unusual decision. About three weeks before her due date, Szabo moved nearly six hours away from their home in Page, Arizona, to Phoenix to give birth at a hospital that does permit women to have VBACs".
Isn't this a lovely photo? Joy Szabo and her baby Marcus after a normal birth on 5th December.
The hospital executives made the claim that VBAC's have slightly higher risks for complications? Compared to what? Normal births? Repeat caesareans? Don't they understand that it is the way that women are treated during childbearing that leads to either lower or higher risks of complications????
Mom fights, gets the delivery she wants - CNN.com
Thursday 17 December 2009
Newborn care key to baby’s survival—DoH - INQUIRER.net, Philippine News for Filipinos
"MANILA, Philippines—The current practice of handling newborns, like clamping and cutting the umbilical cord and washing the baby right after birth, have been known to actually contribute to the high incidence of neonatal deaths and illnesses in the country.
“This is a paradigm shift,” was how Director Honorata Catibog, head of the Department of Health (DoH) task force on the rapid reduction of maternal and neonatal mortality, described the new program introduced by the DoH and the World Health Organization.
Proponents of the Essential Newborn Care (ENC) are changing the protocol currently observed by childbirth
practitioners.
The ENC protocol prioritizes drying the newborn and initiating skin contact with the mother before clamping and cutting the umbilical cord. It prescribes a proper sequence of interventions that even a single health worker could perform and calls for initiating breastfeeding within the first hour of life".
Newborn care key to baby’s survival—DoH - INQUIRER.net, Philippine News for Filipinos
“This is a paradigm shift,” was how Director Honorata Catibog, head of the Department of Health (DoH) task force on the rapid reduction of maternal and neonatal mortality, described the new program introduced by the DoH and the World Health Organization.
Proponents of the Essential Newborn Care (ENC) are changing the protocol currently observed by childbirth
practitioners.
The ENC protocol prioritizes drying the newborn and initiating skin contact with the mother before clamping and cutting the umbilical cord. It prescribes a proper sequence of interventions that even a single health worker could perform and calls for initiating breastfeeding within the first hour of life".
Newborn care key to baby’s survival—DoH - INQUIRER.net, Philippine News for Filipinos
Monday 14 December 2009
GOVERNMENT BACKFLIP ON MIDWIVES
Family First Leader Senator Steve Fielding has welcomed the decision by the Health Minister to back down on its controversial plan to drive homebirths underground.
...now the government says it won’t force midwives to work in formal collaborative arrangements with doctors as a condition of insurance.
"The Rudd Government's backflip proves they clearly underestimated how important this issue was to Australian women,” Senator Fielding said.
“Women should have the right to choose whether they want to have a birth in a hospital or at home, and midwives that assist in either case should be able to access affordable indemnity cover.
How I love intelligent, thinking men! Senator Fielding, not only believes women have the right to be self determining, he even reads the research and understands it. (wonder if dynamic Dr 3am has read this report?)
“Numerous studies have shown that for low-risk women with appropriate transfer-to-hospital options available, homebirths are at least as safe as births in hospitals or birth centres.”
GOVERNMENT BACKFLIP ON MIDWIVES
...now the government says it won’t force midwives to work in formal collaborative arrangements with doctors as a condition of insurance.
"The Rudd Government's backflip proves they clearly underestimated how important this issue was to Australian women,” Senator Fielding said.
“Women should have the right to choose whether they want to have a birth in a hospital or at home, and midwives that assist in either case should be able to access affordable indemnity cover.
How I love intelligent, thinking men! Senator Fielding, not only believes women have the right to be self determining, he even reads the research and understands it. (wonder if dynamic Dr 3am has read this report?)
“Numerous studies have shown that for low-risk women with appropriate transfer-to-hospital options available, homebirths are at least as safe as births in hospitals or birth centres.”
GOVERNMENT BACKFLIP ON MIDWIVES
Midwives damn AMA-induced amendments to maternity reform – Crikey
Midwives damn AMA-induced amendments to maternity reform
A wonderful piece of writing by two of our leading midwifery professors. Clear, reasoned, succinct and accurate in the description of the threat to women's self sovereignty and midwives and nurse practitioners' right to practice unimpeded posed by the power laden antics of the likes of dynamic Dr 3am and his union.
Midwives damn AMA-induced amendments to maternity reform – Crikey
Sunday 13 December 2009
Dynamic Dr 3am responds about his greatest achievement
Dr Pesce, self appointed arbiter for birthing women's and the unborn child's safety, has this to say in response to various letters in the Age newspaper after the article on his dynamic ability to influence the Federal Minister of Health, the Honorable Nicola Roxon. There is another letter following by someone else on the same issue.
I consider my greatest achievement thus far was promoting to Government a collaborative care amendment to legislation before the Parliament. This amendment underpins the importance of doctors and nurses and doctors and midwives working together to provide the best quality care for our patients. It confirms in legislation the recommendation of the Maternity Services Review.
The amendment does not impact in any way on the existing arrangements for midwives providing care for women who choose home birth. These midwives are exempted from the requirement to carry indemnity insurance, provided they inform their patients that they are not indemnified, and meet reporting requirements that will be overseen by the Victorian Health Department.
Similarly, in line with the recommendations of the Maternity Services Review, midwifery care for home birth will not be funded by the Commonwealth, so the amendment in no way impacts on midwives who currently provide care for women choosing home birth.
Dr ANDREW PESCE, federal AMA president
One assumes that the statistics speak for themselves. In the 19th century, when home birth was common, the death rate was more than 1 per cent of live births, leading to the development of women's hospitals specialising in gynaecological care.
While most home births are successful without intervention, so are births in hospital. However, when intervention is required, specialist help is immediately available. Women choosing home birth should be required to sign an undertaking recognising the risks that they are assuming on half of themselves and their unborn child, and to provide an indemnity to any service provider other than their midwife in the event of a crisis.
GREG ANGELO, Balwyn North
Park and ride instead
Raising the bar
IT HAS been claimed that in an interview with The Sunday Age, I stated my greatest achievement so far as AMA president was to curtail a woman's choice to choose a home birth. This is not correct.I consider my greatest achievement thus far was promoting to Government a collaborative care amendment to legislation before the Parliament. This amendment underpins the importance of doctors and nurses and doctors and midwives working together to provide the best quality care for our patients. It confirms in legislation the recommendation of the Maternity Services Review.
The amendment does not impact in any way on the existing arrangements for midwives providing care for women who choose home birth. These midwives are exempted from the requirement to carry indemnity insurance, provided they inform their patients that they are not indemnified, and meet reporting requirements that will be overseen by the Victorian Health Department.
Similarly, in line with the recommendations of the Maternity Services Review, midwifery care for home birth will not be funded by the Commonwealth, so the amendment in no way impacts on midwives who currently provide care for women choosing home birth.
Dr ANDREW PESCE, federal AMA president
At what risk?
PASSIONATE single-issue advocates have been hard at work flooding The Sunday Age with pro-home birth propaganda. But who is looking after the interests of the unborn child?One assumes that the statistics speak for themselves. In the 19th century, when home birth was common, the death rate was more than 1 per cent of live births, leading to the development of women's hospitals specialising in gynaecological care.
While most home births are successful without intervention, so are births in hospital. However, when intervention is required, specialist help is immediately available. Women choosing home birth should be required to sign an undertaking recognising the risks that they are assuming on half of themselves and their unborn child, and to provide an indemnity to any service provider other than their midwife in the event of a crisis.
GREG ANGELO, Balwyn North
Park and ride instead
Chloë's Birth Story
Thanks so much to Emma for permission to share this precious time. The images are beautiful, the words are precious. The experience is something those of us who work with women wish for all birthing women and their babies.
Chloë's Birth Story
Chloë's Birth Story
Planned-Home-Births.pdf (application/pdf Object)
Amidst all the predictable power based rhetoric about birth place and care provider from the Australian doctors' union, led by the self appointed arbiter on women's choice and midwives' freedom to practice, Dr Andrew Pesce, there is a beacon of light on the subject from British Columbia
The College of Physicians and Surgeons of British Columbia have just released their position statement, which says:
The College’s Position
The College supports a woman’s right to personal autonomy and decision making in obstetrical care.
Planned-Home-Births.pdf (application/pdf Object)
Updated November 2009
Board Approved December 2009
Although this statement does not go as far as saying that homebirth is safe and that homebirth is a wise choice, as the evidence from around the world clearly demontrates it is, the statement does provide an indication that at last (some) doctors are officially recognising that women are autonomous and have rights. This recognition of women's rights is a step in the right direction for a profession which has traditionally, well, at least for the last couple of hundred years or so, positioned itself as the powerful elite.
This statement is refreshing news and makes Dr Andrew Pesce's posturing on his ability to influence The Australian Minister of Health, the Honourable Nicola Roxon to remove and restrict choice in both birth place and practitioner for childbearing women and limit the practice of midwives, appear as sad, pathetic and out of step with evidence informed practice as it is.
Not only has Dr Pesce got his sights on controlling midwives and birthing women, he and his other unionists are also seeking to deprive the Australian public of another group of excellent health professionals, the Nurse Practitioners. Australia has seen the 'turf wars' raging for several decades now, as doctors use power tactics to keep control of the health system and ensure nurses, midwives, patients and childbearing women remain subservient.
However, the winds of change are blowing.
The disgraceful thing is that while some Australian doctors seek to live in a time warp and glorify the days when doctors were gods, nurses and midwives were handmaidens and patients and childbearing women were subservient by undermining initiatives to improve choice and access to optimal health care, they will unnecessarily hamper true progress in health and health care provision.
The College of Physicians and Surgeons of British Columbia have just released their position statement, which says:
The College’s Position
The College supports a woman’s right to personal autonomy and decision making in obstetrical care.
Planned-Home-Births.pdf (application/pdf Object)
Updated November 2009
Board Approved December 2009
Although this statement does not go as far as saying that homebirth is safe and that homebirth is a wise choice, as the evidence from around the world clearly demontrates it is, the statement does provide an indication that at last (some) doctors are officially recognising that women are autonomous and have rights. This recognition of women's rights is a step in the right direction for a profession which has traditionally, well, at least for the last couple of hundred years or so, positioned itself as the powerful elite.
This statement is refreshing news and makes Dr Andrew Pesce's posturing on his ability to influence The Australian Minister of Health, the Honourable Nicola Roxon to remove and restrict choice in both birth place and practitioner for childbearing women and limit the practice of midwives, appear as sad, pathetic and out of step with evidence informed practice as it is.
Not only has Dr Pesce got his sights on controlling midwives and birthing women, he and his other unionists are also seeking to deprive the Australian public of another group of excellent health professionals, the Nurse Practitioners. Australia has seen the 'turf wars' raging for several decades now, as doctors use power tactics to keep control of the health system and ensure nurses, midwives, patients and childbearing women remain subservient.
However, the winds of change are blowing.
The disgraceful thing is that while some Australian doctors seek to live in a time warp and glorify the days when doctors were gods, nurses and midwives were handmaidens and patients and childbearing women were subservient by undermining initiatives to improve choice and access to optimal health care, they will unnecessarily hamper true progress in health and health care provision.
Saturday 12 December 2009
US C-section rate up 85% in decade 1997-2007
HCUP Facts and Figures 2007 - Section 3
The mission of the Agency for Healthcare Research and Quality (AHRQ) is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.
"C-section was the most frequent major operating room procedure—performed on 1.5 million women in 2007. Growth in C-sections, up 85 percent between 1997 and 2007, outpaced increases in most other frequently performed maternal procedures and was among the fastest growing procedures for women 18-44 years old"
Section 3
The mission of the Agency for Healthcare Research and Quality (AHRQ) is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.
"C-section was the most frequent major operating room procedure—performed on 1.5 million women in 2007. Growth in C-sections, up 85 percent between 1997 and 2007, outpaced increases in most other frequently performed maternal procedures and was among the fastest growing procedures for women 18-44 years old"
Section 3
Cartoon commentary on social environment and attachment parenting
Arun is the clever artist/cartoonist and delightful blogger of his life and experiences as a homeschooling dad. Apart from his excellent cartoons and other commentary, his site contains many gems, including my personal favourite 12 exercises for Mindful Parenting
http://theparentingpit.com/alternative-parenting/mindfulparenting/
For any parent or parent to be, you will find many articles and ideas to consider for yourself in relation to what sort of parent you want to be.
Study shows how gene action may lead to diabetes prevention, cure
Exciting developments in the field!
"A gene commonly studied by cancer researchers has been linked to the metabolic inflammation that leads to diabetes.
Understanding how the gene works means scientists may be closer to finding ways to prevent or cure diabetes, according to a study by Texas AgriLife Research appearing in the Journal of Biological Chemistry.
"Because we understand the mechanism, or how the gene works, we believe a focus on nutrition will find the way to both prevent and reverse diabetes," said Dr. Chaodong Wu, AgriLife Research nutrition and food scientist who authored the paper with the University of Minnesota's Dr. Yuqing Hou.
Wu said the research team will collaborate with nutritionists to identify what changes or supplements in a diet will activate the gene to prevent or stop the progression of diabetes".
Nutrition folks! Nutrition, nutrition, nutrition.
And.
Manage your stressors! Turn on the parasympathetic nervous system pathways, keep your nervous system happily calibrating back to a calm, relaxed state and ensure the disease carrying genes are kept switched off; while switching on and keeping on the genes that keep us well.
The role of inflammatory processes in much of what ails us, including premature labour, pre-eclampsia and diabetes - scourges for childbearing women and their babies, is becoming more and more widely recognised.
Inflammatory processes are switched on by numerous environmental factors such as chronic stress (aka cortisols etc), poor nutrition, toxins, lack of exercise and stasis of lymph fluid; feelings generated by social isolation and not feeling/being valued or loved and/or being in a hostile environment to name a few 'biggies'.
Exercise, relaxation, good nutrition, being surrounded by loving people and the ability to talk about what is important to you and bothers you, while being listened to and respected are all environmentally controllable elements which contribute to optimal psychophysiological functioning.
No wonder one to one midwifey care is associated with better heath outcomes for women and babies.
Study shows how gene action may lead to diabetes prevention, cure
"A gene commonly studied by cancer researchers has been linked to the metabolic inflammation that leads to diabetes.
"Because we understand the mechanism, or how the gene works, we believe a focus on nutrition will find the way to both prevent and reverse diabetes," said Dr. Chaodong Wu, AgriLife Research nutrition and food scientist who authored the paper with the University of Minnesota's Dr. Yuqing Hou.
Wu said the research team will collaborate with nutritionists to identify what changes or supplements in a diet will activate the gene to prevent or stop the progression of diabetes".
Nutrition folks! Nutrition, nutrition, nutrition.
And.
Manage your stressors! Turn on the parasympathetic nervous system pathways, keep your nervous system happily calibrating back to a calm, relaxed state and ensure the disease carrying genes are kept switched off; while switching on and keeping on the genes that keep us well.
The role of inflammatory processes in much of what ails us, including premature labour, pre-eclampsia and diabetes - scourges for childbearing women and their babies, is becoming more and more widely recognised.
Inflammatory processes are switched on by numerous environmental factors such as chronic stress (aka cortisols etc), poor nutrition, toxins, lack of exercise and stasis of lymph fluid; feelings generated by social isolation and not feeling/being valued or loved and/or being in a hostile environment to name a few 'biggies'.
Exercise, relaxation, good nutrition, being surrounded by loving people and the ability to talk about what is important to you and bothers you, while being listened to and respected are all environmentally controllable elements which contribute to optimal psychophysiological functioning.
No wonder one to one midwifey care is associated with better heath outcomes for women and babies.
Study shows how gene action may lead to diabetes prevention, cure
American Academy of Family Physicians Launches Consumer Alliance With First Partner: The Coca-Cola Company -- Media Center -- American Academy of Family Physicians
I read on Belly Belly http://www.bellybelly.com.au/ that the American Academy of Family Physicians partnered with Coca Cola. I found that hard to believe so went to the source and sure enough, there on the AAFP's website was the proudly stated announcement that on the 6th October, the AAFP announced the Consumer Alliance, a new corporate partnership program, with its first alliance partner, The Coca-Cola Company.
According to the media release:
"The Consumer Alliance is a program that allows corporate partners like The Coca-Cola Company to work with the AAFP to educate consumers about the role their products can play in a healthy, active lifestyle".
Coca Cola? Healthy active lifestyle? What role Coca Cola's products can play? What a minute! Isn't Coca Cola full of sugar? Isn't obesity increasingly associated with a frighteningly increasing list of health problems for people in the western world?
The media release continues:
"As part of this partnership, The Coca-Cola Company is providing a grant to the AAFP to develop consumer education content on beverages and sweeteners for FamilyDoctor.org, an award-winning consumer health and wellness resource".
Aha! Money. This buy ability and the subliminally associated street credibility is why no company that manufactures breastmilk substitutes is able to fund midwifery or breastfeeding related educational materials or conferences (for ethically sound organisations)
"The AAFP recognizes the significant influence that consumer companies have on consumer health,” said Lori Heim, M.D., president-elect of the AAFP. “We look forward to working with The Coca-Cola Company, and other companies in the future, on the development of educational materials to teach consumers how to make the right choices and incorporate the products they love into a balanced diet and a healthy lifestyle.”
This statement would be really really funny if it weren't so sad and distressing.
"About the AAFP Consumer Alliance
In addition to health care providers, AAFP recognizes that consumer products companies have significant influence over consumer health. Therefore, the Consumer Alliance is a strategy whereby AAFP aims to partner with companies who demonstrate good corporate stewardship and a strategic focus on consumer health."
My understanding is that we all have blind spots. Our role as health professionals is to examine evidence and use evidence to inform our practice, seeking to identify and overcome our blind spots, gaps in information and overall ignorance.
Seemingly, we can convince ourselves of anything if the reward is great enough.
The aafp News Now newsletter November 2009 • Volume 5 • Number 11 (online) states proudly:
http://www.aafp.org/online/etc/medialib/aafp_org/documents/news_pubs/ann/monthly-pdfs/november-09-pdf.Par.0001.File.dat/Nov09-ANN.pdf
"The Consumer Alliance program also will create a new source of funding for AAFP, which, in recent years, has broadened its search for funding outside the pharmaceutical industry. “We’ve made a conscious effort to diversify our sources of revenue,” Heim said. “This is the first of what we hope will be many Consumer Alliance agreements".
American Academy of Family Physicians Launches Consumer Alliance With First Partner: The Coca-Cola Company -- Media Center -- American Academy of Family Physicians
According to the media release:
"The Consumer Alliance is a program that allows corporate partners like The Coca-Cola Company to work with the AAFP to educate consumers about the role their products can play in a healthy, active lifestyle".
Coca Cola? Healthy active lifestyle? What role Coca Cola's products can play? What a minute! Isn't Coca Cola full of sugar? Isn't obesity increasingly associated with a frighteningly increasing list of health problems for people in the western world?
The media release continues:
"As part of this partnership, The Coca-Cola Company is providing a grant to the AAFP to develop consumer education content on beverages and sweeteners for FamilyDoctor.org, an award-winning consumer health and wellness resource".
Aha! Money. This buy ability and the subliminally associated street credibility is why no company that manufactures breastmilk substitutes is able to fund midwifery or breastfeeding related educational materials or conferences (for ethically sound organisations)
"The AAFP recognizes the significant influence that consumer companies have on consumer health,” said Lori Heim, M.D., president-elect of the AAFP. “We look forward to working with The Coca-Cola Company, and other companies in the future, on the development of educational materials to teach consumers how to make the right choices and incorporate the products they love into a balanced diet and a healthy lifestyle.”
This statement would be really really funny if it weren't so sad and distressing.
"About the AAFP Consumer Alliance
In addition to health care providers, AAFP recognizes that consumer products companies have significant influence over consumer health. Therefore, the Consumer Alliance is a strategy whereby AAFP aims to partner with companies who demonstrate good corporate stewardship and a strategic focus on consumer health."
My understanding is that we all have blind spots. Our role as health professionals is to examine evidence and use evidence to inform our practice, seeking to identify and overcome our blind spots, gaps in information and overall ignorance.
Seemingly, we can convince ourselves of anything if the reward is great enough.
The aafp News Now newsletter November 2009 • Volume 5 • Number 11 (online) states proudly:
http://www.aafp.org/online/etc/medialib/aafp_org/documents/news_pubs/ann/monthly-pdfs/november-09-pdf.Par.0001.File.dat/Nov09-ANN.pdf
"The Consumer Alliance program also will create a new source of funding for AAFP, which, in recent years, has broadened its search for funding outside the pharmaceutical industry. “We’ve made a conscious effort to diversify our sources of revenue,” Heim said. “This is the first of what we hope will be many Consumer Alliance agreements".
American Academy of Family Physicians Launches Consumer Alliance With First Partner: The Coca-Cola Company -- Media Center -- American Academy of Family Physicians
Tragic suicide of a New Midwife after she wrongly thought she was to blame for baby's death | Mail Online
What a sad, tragic loss of a beautiful, enthusiastic young woman on the start of her midwifery journey.
Theresa Naish's despair and her distraught response to the sad and distressing loss of a baby following an obviously precipitate labour and birth of an 'at risk' baby raises so many questions about how this hospital runs, how information is shared, how problems are flagged so staff are aware of potential problems and how new staff members and junior staff members are treated. How is it that this baby's situation wasn't 'known' by all the seniors on duty? How is it that a well articulated plan for the birth of this baby wasn't given a high priority? How is that the plans and needs for this baby weren't clearly documented/flagged so that everyone could immediately see, from the notes, that the baby was 'at risk'?
From this statement:
'She did amazingly well to get the mother to the labour ward as quickly as she did".
it would seem the mother was on the antenatal ward when Theresa came on duty. Theresa clearly noted the woman was in labour and took her to the Birthing suite.
This disturbing event illuminates our responsibilities in health care to ensure that our staff are well supported by processes and structures that facilitate appropriate communication of any woman/fetus/baby needs and presenting problems.
Theresa's death is a stark reminder that when adverse events occur in health care, as they do, that the staff who were involved in the situation and the families of the afflicted person need, deserve and must get the best possible support to help them negotiate and deal with the emotions that rage after such an event.
Theresa's suicide indicates that she had a caring and sensitive nature and was distressed at feeling responsible for the baby's death. I sometimes hear midwives say things like "I couldn't live with myself if I did anything wrong". Midwives who say things like that are the sensitive, caring, respectful, gentle souls whose passion is palpable. Theresa perhaps felt like that.
Midwifery is mostly about joy and happiness. Occasionally our work involves tragedy. When there is a a distressing event, we have to do more to prevent another tragedy like Theresa's suicide. We can't afford to lose bright, sensitive, caring midwives like Theresa.
King's College Hospital would be examining their processes to improve them. We all need to learn from Theresa so her death is not in vain.
Sincere condolences to Theresa's parents, sister, relatives and friends. Sincere condolences to the mother and relatives of the little baby. Words are never easy and never enough at these sad times, but please know that people's hearts are with you.
Midwife hangs herself after she wrongly thought she was to blame for baby's death | Mail Online
Theresa Naish's despair and her distraught response to the sad and distressing loss of a baby following an obviously precipitate labour and birth of an 'at risk' baby raises so many questions about how this hospital runs, how information is shared, how problems are flagged so staff are aware of potential problems and how new staff members and junior staff members are treated. How is it that this baby's situation wasn't 'known' by all the seniors on duty? How is it that a well articulated plan for the birth of this baby wasn't given a high priority? How is that the plans and needs for this baby weren't clearly documented/flagged so that everyone could immediately see, from the notes, that the baby was 'at risk'?
From this statement:
'She did amazingly well to get the mother to the labour ward as quickly as she did".
it would seem the mother was on the antenatal ward when Theresa came on duty. Theresa clearly noted the woman was in labour and took her to the Birthing suite.
This disturbing event illuminates our responsibilities in health care to ensure that our staff are well supported by processes and structures that facilitate appropriate communication of any woman/fetus/baby needs and presenting problems.
Theresa's death is a stark reminder that when adverse events occur in health care, as they do, that the staff who were involved in the situation and the families of the afflicted person need, deserve and must get the best possible support to help them negotiate and deal with the emotions that rage after such an event.
Theresa's suicide indicates that she had a caring and sensitive nature and was distressed at feeling responsible for the baby's death. I sometimes hear midwives say things like "I couldn't live with myself if I did anything wrong". Midwives who say things like that are the sensitive, caring, respectful, gentle souls whose passion is palpable. Theresa perhaps felt like that.
Midwifery is mostly about joy and happiness. Occasionally our work involves tragedy. When there is a a distressing event, we have to do more to prevent another tragedy like Theresa's suicide. We can't afford to lose bright, sensitive, caring midwives like Theresa.
King's College Hospital would be examining their processes to improve them. We all need to learn from Theresa so her death is not in vain.
Sincere condolences to Theresa's parents, sister, relatives and friends. Sincere condolences to the mother and relatives of the little baby. Words are never easy and never enough at these sad times, but please know that people's hearts are with you.
Midwife hangs herself after she wrongly thought she was to blame for baby's death | Mail Online
Friday 11 December 2009
‘Survival of the Kindest’ – Sympathy is Strongest Human Instinct
“Because of our very vulnerable offspring, the fundamental task for human survival and gene replication is to take care of others,” said Keltner, co-director of UC Berkeley’s Greater Good Science Center. “Human beings have survived as a species because we have evolved the capacities to care for those in need and to cooperate. As Darwin long ago surmised, sympathy is our strongest instinct.”
Empathy in our genes
Keltner’s team is looking into how the human capacity to care and cooperate is wired into particular regions of the brain and nervous system. One recent study found compelling evidence that many of us are genetically predisposed to be empathetic".
‘Survival of the Kindest’ – Sympathy is Strongest Human Instinct
Empathy in our genes
Keltner’s team is looking into how the human capacity to care and cooperate is wired into particular regions of the brain and nervous system. One recent study found compelling evidence that many of us are genetically predisposed to be empathetic".
‘Survival of the Kindest’ – Sympathy is Strongest Human Instinct
Bacteria offer insights into human decision making
Fascinating! Provides insight into why good communication skills are important with childbearing women and ensuring true, informed choice. Application of the learning from simple bacteria to the way medicine approaches maternity care could revolutionise the way women are provided with information and supported to make choices about what is right for them.
As the researchers note:
"We learned a simple rule: Anyone who needs to make a decision under pressure in life, especially if it is a possible death decision, will take its time. She or he will review the trends of change, will render all possible chances and risks, and only then react."
Bacteria offer insights into human decision making
As the researchers note:
"We learned a simple rule: Anyone who needs to make a decision under pressure in life, especially if it is a possible death decision, will take its time. She or he will review the trends of change, will render all possible chances and risks, and only then react."
Bacteria offer insights into human decision making
Scientists discover first evidence of brain rewiring in children
Aren't our brains amazing?
"Carnegie Mellon University scientists Timothy Keller and Marcel Just have uncovered the first evidence that intensive instruction to improve reading skills in young children causes the brain to physically rewire itself, creating new white matter that improves communication within the brain".
Scientists discover first evidence of brain rewiring in children
"Carnegie Mellon University scientists Timothy Keller and Marcel Just have uncovered the first evidence that intensive instruction to improve reading skills in young children causes the brain to physically rewire itself, creating new white matter that improves communication within the brain".
Scientists discover first evidence of brain rewiring in children
Ovaries must suppress their inner male
"This shows that the maintenance of the ovarian phenotype is an active process throughout life," Treier said. "Like Yin and Yang, FOXL2 and SOX9 oppose each other's action to ensure together the establishment and maintenance of the different female and male supporting cell types respectively."
Further analysis showed that FOXL2 works in cooperation with the estrogen receptor to repress Sox9. Without FOXL2, the estrogen receptor fails to work suggesting that loss of estrogen levels could lead to sex reversal. Treier suspects that this mechanism might underlie the occasional signs of masculinization seen in menopausal women.
"When estrogen declines [in menopause], part of the ovary may switch to a testicle-like structure," he said."
Ovaries must suppress their inner male
Further analysis showed that FOXL2 works in cooperation with the estrogen receptor to repress Sox9. Without FOXL2, the estrogen receptor fails to work suggesting that loss of estrogen levels could lead to sex reversal. Treier suspects that this mechanism might underlie the occasional signs of masculinization seen in menopausal women.
"When estrogen declines [in menopause], part of the ovary may switch to a testicle-like structure," he said."
Ovaries must suppress their inner male
Research finds the mum-bub bond may reduce neglect
Another study which provides insight into the importance of one to one midwifery. A midwife working in a primary health care, one to one relationship with a childbearing woman can provide a safe, supported and trusting 'space' where that woman (and her partner) can explore what having her baby means to her/them. In the context of that relationship, the midwife can promote prenatal bonding and breastfeeding, leading to an improved mother-child relationship.
"This study emphasises the need to address the basic, universal needs of children, and stresses the importance of this early mother-infant relationship.
"Strengthening this crucial relationship may help to prevent some of the long term consequences of neglect that we are seeing more commonly today, such as delinquency, crime, developmental delay and psychiatric disorders."
Research finds the mum-bub bond may reduce neglect
"This study emphasises the need to address the basic, universal needs of children, and stresses the importance of this early mother-infant relationship.
"Strengthening this crucial relationship may help to prevent some of the long term consequences of neglect that we are seeing more commonly today, such as delinquency, crime, developmental delay and psychiatric disorders."
Research finds the mum-bub bond may reduce neglect
Wednesday 9 December 2009
Monday 7 December 2009
Irish Medical Times | News | Docs blamed for Caesarean rate
Who would have thought?
Irish Medical Times | News | Docs blamed for Caesarean rate
Perhaps we have something to learn from the elephants?
Irish Medical Times | News | Docs blamed for Caesarean rate
Perhaps we have something to learn from the elephants?
Sunday 6 December 2009
An attack on women's rights
Letters in the Age in response to Dr Andrew Pesce, president of the Australian Medical Association (AMA) claiming his greatest achievement in that role is having been able to successfully lobby Federal Health Minister Nicola Roxon to make amendments to home birth legislation
An attack on women's rights
An attack on women's rights
Saturday 5 December 2009
If Loved Ones Lessen Our Perceptions of Pain, Do Enemies Make Them Worse? Sarah Master Answers - Science and Religion Today
A great reason to surround ourselves with people we feel good with! Which of course, has implications for birthing women. Midwives have to be good to be around. Birthing women need to be surrounded by people they love and who love and support them for optimal psychophysiological functioning, which includes not only oxytocin release, but includes the endogenous opiods. So, it can be seen, that not just enemies make things worse, but anyone who is not fully 'present' for the woman in labour, therefore setting off her 'alarm' system, can make things worse.
If Loved Ones Lessen Our Perceptions of Pain, Do Enemies Make Them Worse? Sarah Master Answers - Science and Religion Today
If Loved Ones Lessen Our Perceptions of Pain, Do Enemies Make Them Worse? Sarah Master Answers - Science and Religion Today
Embodied Cognition: Using Movement to Understand the Mind
This study is interesting as it provides an insight into the midwifery maxim first articulated by Ina May Gaskin "fix the mind, fix the body; fix the body, fix the mind". Ina May's midwifery maxim points to a deep understanding of how the nervous system is an embodied system. When we get an appreciation of how the way we think and feel affects the way our body functions, not just in gross physical communication movements but at all levels of movement, (including cellular communication, chemical communication etc) throughout the body, we come to see that attending to the holistic aspects of being is the best way to optimise health.
A clear understanding of the way the mind and the body are inextricably interconnected and integrated helps to explain why midwives work with childbearing women to meet childbearing women's emotional, physical, spiritual, cultural and psychological needs and desires regarding the births of their babies. What some people refer to as 'woo woo' psychobabble or pseudoscience is actually sound midwifery practice.
Embodied Cognition: Using Movement to Understand the Mind
"Interpersonal communication is more than just the exchange of words. Speech, gaze and body coordination are all utilized during conversation. A common example, such as hand gesturing while speaking, shows effective communication is more than just a linguistic dynamic.
This phenomenon, called embodied communication, is the focus of a new study by University of Cincinnati professors in the Department of Psychology.
“Collaborative Research: Dynamics of Interpersonal Coordination and Embodied Communication” is a $418,809 National Science Foundation grant given to Associate Professors Kevin Shockley, Michael Riley and Assistant Professor Michael Richardson to understand coordination of thought by studying coordination of action.
“We’re using movement as a window to understand how people coordinate their thinking,” says Shockley, the principal investigator for the study. “Normally people don’t think of movement when they hear about psychology, but that’s unfortunate because the embodied cognition approach illustrates so nicely how movement is integral to our understanding of the mind.”
A clear understanding of the way the mind and the body are inextricably interconnected and integrated helps to explain why midwives work with childbearing women to meet childbearing women's emotional, physical, spiritual, cultural and psychological needs and desires regarding the births of their babies. What some people refer to as 'woo woo' psychobabble or pseudoscience is actually sound midwifery practice.
Embodied Cognition: Using Movement to Understand the Mind
"Interpersonal communication is more than just the exchange of words. Speech, gaze and body coordination are all utilized during conversation. A common example, such as hand gesturing while speaking, shows effective communication is more than just a linguistic dynamic.
This phenomenon, called embodied communication, is the focus of a new study by University of Cincinnati professors in the Department of Psychology.
“Collaborative Research: Dynamics of Interpersonal Coordination and Embodied Communication” is a $418,809 National Science Foundation grant given to Associate Professors Kevin Shockley, Michael Riley and Assistant Professor Michael Richardson to understand coordination of thought by studying coordination of action.
“We’re using movement as a window to understand how people coordinate their thinking,” says Shockley, the principal investigator for the study. “Normally people don’t think of movement when they hear about psychology, but that’s unfortunate because the embodied cognition approach illustrates so nicely how movement is integral to our understanding of the mind.”
Thursday 3 December 2009
Meet Mr 3am: the nation's dynamic top doctor
Known for his candour and willingness to speak his mind, the 49-year-old has made his presence felt at the negotiating table as the Federal Government attempts to push through health reforms.
He successfully lobbied Health Minister Nicola Roxon to make amendments to home birth legislation, ensuring that midwives would be denied Medicare payments unless they could prove they were working collaboratively with doctors.
The home birth lobby claimed the changes curtail a woman's right to choose how she gives birth, but Dr Pesce cites it as his greatest achievement so far as AMA president.
Meet Mr 3am: the nation's dynamic top doctor
He successfully lobbied Health Minister Nicola Roxon to make amendments to home birth legislation, ensuring that midwives would be denied Medicare payments unless they could prove they were working collaboratively with doctors.
The home birth lobby claimed the changes curtail a woman's right to choose how she gives birth, but Dr Pesce cites it as his greatest achievement so far as AMA president.
Meet Mr 3am: the nation's dynamic top doctor
Parliament of Australia: Senate: Committees: Community Affairs: Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills
Urgent call to send submissions to the Senate by the 11th December 2009. Have your say on the future of maternity services in Australia
You can find the terms of reference for the inquiry and copies of the Bills here:
http://www.aph.gov.au/Senate/committee/clac_ctte/health_leg_midwives_nurse_practitioners_09_nov09/index.htm... See More
Parliament of Australia: Senate: Committees: Community Affairs: Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills
You can find the terms of reference for the inquiry and copies of the Bills here:
http://www.aph.gov.au/Senate/committee/clac_ctte/health_leg_midwives_nurse_practitioners_09_nov09/index.htm... See More
Parliament of Australia: Senate: Committees: Community Affairs: Inquiry into Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills
Wednesday 2 December 2009
Medical News: Insect Repellent Use Associated with Hypospadias - in Public Health & Policy, Environmental Health from MedPage Today
Infants born to mothers who used insect repellent during the first trimester of pregnancy were more likely to have hypospadias (OR 1.81, 95% CI 1.06 to 3.11) after adjusting for other factors, according to a report published online Nov. 30 in Occupational and Environmental Medicine.
Medical News: Insect Repellent Use Associated with Hypospadias - in Public Health & Policy, Environmental Health from MedPage Today
Medical News: Insect Repellent Use Associated with Hypospadias - in Public Health & Policy, Environmental Health from MedPage Today
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