What is the difference between an Eligible Midwife and a Doula
- Details
- Published on Thursday, 27 October 2011 15:17
- Written by Ginny
WHAT IS THE DIFFERENCE BETWEEN A MIDWIFE an a DOULA?
Using Wikidepia as a reference, this is the basic difference.
MIDWIFE
According to the International Confederation of Midwives (a definition that has also been adopted by the World Health Organization and the International Federation of Gynecology and Obstetrics):
A midwife is a person who, having been regularly admitted to a midwifery educational program that is duly recognized in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery.
The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labor and the postpartum period, to conduct births on the midwife's own responsibility and to provide care for the infant. This care includes preventive measures, the promotion of normal birth, the detection of complications in mother and child, accessing of medical or other appropriate assistance and the carrying out of emergency measures.
The midwife has an important task in health counseling and education, not only for the woman, but also within the family and community. This work should involve antenatal education and preparation for parenthood and may extend to women's health, sexual or reproductive health and childcare, and to gain the knowledge to counteract the lack of pain relievers and antiseptics.
A midwife may practice in any setting including in the home, the community, hospitals, clinics or health units.
In late 2011 the Nursing and Midwifery Board of Australia adopted a new standard called, Eligible Midwives. Some of the new changes include her ability to prescribe scheduled medical prescriptions, order diagnostic investigations as well as many other medical services not previously allowed.
On 1 November 2010, new laws came into effect that give eligible nurse practitioners and midwives access to specific items in the Medicare Benefits Schedule (MBS) and access to a limited list of items under the Pharmaceutical Benefits Scheme (PBS).
DOULA
A doula offers emotional support; she's essentially a labor coach.
A labor doula or birth doula is someone (often trained, though this is not required) who provides non-medical support (physical and emotional) to a woman leading up to and during her labor and delivery, an aspect of care that was traditionally practiced in midwifery. A labor doula may attend a woman having a home birth or a woman laboring at home before transporting to a hospital or a birth center, where she will continue support. Doulas do not perform clinical duties such as heart rate checks or vaginal exams, or give medical advice. Labor doulas rely on techniques like massage, aromatherapy, visualization, positive positioning, emotional support, encouragement, and nurturing to help women through labor. Many offer phone and email support as well as prenatal and postpartum visits to ensure the mother is informed and supported. The terms of a labor/birth doula's responsibilities are decided between the doula and the family. The doula is also an ally for the father or partner, who may have little experience with the labor process and may also find the process anxiety provoking. Often the doula will help the partner find ways to support the laboring woman. Studies have shown that childbirth education can help reduce paternal anxiety and one of the doula's roles is to educate. A responsible doula supports, encourages, and educates the father or partner in his or her support style rather than replacing them.
Eligible Midwife
- Details
- Published on Friday, 21 October 2011 07:17
- Written by Ginny
On 1 November 2010, new laws came into effect that give eligible nurse practitioners and midwives access to specific items in the Medicare Benefits Schedule (MBS) and access to a limited list of items under the Pharmaceutical Benefits Scheme (PBS).
To be eligible to access these services they must apply for a Medicare provider number and PBS prescriber number.
How are they eligible?
To be eligible for a Medicare provider number they must:
- be registered under the National Registration Accreditation Scheme, and
- be endorsed as a nurse practitioner by the Nursing and Midwifery Board of Australia, or
- be notated as an eligible midwife by the Nursing and Midwifery Board of Australia, and
- be in private practice to access MBS services, refer to specific specialists and request some pathology and diagnostic items.
To be eligible for a PBS prescriber number they must:
- be registered under the National Registration Accreditation Scheme, and
- be endorsed as a nurse practitioner by the Nursing and Midwifery Board of Australia, or
- be notated as an eligible midwife who is qualified to prescribe by the Nursing and Midwifery Board of Australia.
To be identified as a nurse practitioner or eligible midwife, the Board needs to assess their qualifications and experience.
Chorionic Villus Sampling
- Details
- Published on Wednesday, 05 October 2011 20:31
- Written by Ginny
Chorionic villus sampling (CVS)
This is usually performed between 11 and 13 weeks of pregnancy. It is a test that involves taking a small sample of tissue from the developing placenta. This tissue is called the chorionic villi.
The placenta can be tested for chromosomal or DNA abnormalities like Down syndrome.
How is it performed?
The skin of the lower abdomen is cleaned with and alcohol based antiseptic solution. A local anaesthetic is then injected.
Guided by an ultrasound a fine needle is guided into the placenta and a sample is taken (the chorionic villi). A dragging sensation may be felt in the legs or pelvis during the test and this is normal.
How do I prepare?
Your bladder is required to be moderately full. This is so the uterus is lifted out of the pelvis and easily accessible for the needle. An ultrasound will be performed before the test to ensure that your baby is alive and well, look for any abnormalities in the baby and to locate the placenta.
What happens after the test is completed?
The specimen will be sent to a laboratory and processed. It is put in a culture and then an incubator for a few days. After the specimen has divided into enough cells it will be removed and then injected with an enzyme. The chromosomes will then be counted and analysed.
Each of the 23 pairs of chromosomes are stained with a dye and then examined under an ultra violet light. The test will not only exclude Down syndrome but also a variety of other small and major chromosome abnormalities.
After the test you should avoid any strenuous activity for the rest of the day. You may experience some mild cramps after the test. Some vaginal spotting may also be experienced.
When will the results be available?
Generally the results take 11 -14 days, although a preliminary result is available in about 24 hours. This is known as a Flourescent in situ hybridisation (FISH) test. The FISH test can identify about 90% of the common chromosome ploblems such asthe ones involving 13, 18, 21, X or Y. The longer result has an error rate of approximately 1 in 12,000.
What is the risk to my baby?
The risk of miscarriage is about 1 in 200.
Amniocentesis
- Details
- Published on Thursday, 06 October 2011 07:09
- Written by Ginny
Amniocentesis
Amniocentesis is a procedure where a sample of fluid is removed from around the baby for analysis. The amniotic supports the bay in many ways. It keeps baby in a completely buffered environment. It is full of fetal cells, proteins, and fetal urine. For genetic testing, chromosome analysis, and evaluation of an abnormal AFP test, amniocentesis is usually performed between the 15th and the 20th weeks of pregnancy.
How is it done?
During amniocentesis, fluid is removed by placing a long needle through the abdominal wall into amniotic sac. Sometimes, the woman's skin is injected first with a local anesthetic, but this is sometimes not necessary. Through the procedure an ultrasound is used to guide the needle into the correct part of the amniotic sac. Once the needle is in the sac, a syringe is used to withdraw the clear amber-colored amniotic fluid, resembling urine. The amount of fluid withdrawn depends upon the age of the fetus and the reason for the testing.
The fluid will then be sent for genetic analysis, fetal lung maturity, and any evidence of neural-tube defects such as spina bifida. Any infection present will also be detected. The chromosomes are then extracted and analyzed. It takes about two weeks to perform chromosome analysis.
Risks and Results
For most patients, amniocentesis is a fairly quick and comfortable procedure. Some women experience some uterine cramping or a feeling of faintness. Overall, amniocentesis is a safe procedure with the risk of fetal loss at generally less than 1%. According to the American College of Obstetricians and Gynecologists Practice Bulletin, there is a procedure-related rate of fetal loss ranging from 1/300 to 1/500 procedures. The results for some things such as spina bifida will be available in 2 – 3 days. The other chromosome results will be available in 11 -14 days.
Group B Streptococcus
- Details
- Published on Wednesday, 05 October 2011 19:43
- Written by Ginny
Group B Streptococcus
Group B Strep (GBS) is a naturally occurring bacteria that is found in the body. Even though it is harmless in adults, babies can become seriously ill. The infections it can cause include pneumonia and possibly meningitis.
If you have th bacteria there is a chance that the bacteria can be passed to the baby during the birth. Between 10% and 30% of women carry the bacteria. It is not sexually transmitted.
The majority of babies born to GBS +ve mothers will not be infected but some may develop a serious illness.
How do they check for it?
You will be given the option to collect this specimen yourself or the midwife or doctor can do it for you. A bacterial swab is used.
It takes a few days for the test results to be returned. If you are found to be GBS +ve it will be noted in your file.
Nothing is done until you go into established labour. Antibiotics will be given to you through an IV cannula every four hours until the birth of your baby. This reduces the risk of infecting your baby with the GBS bacteria.
Your baby will be monitored regularly for signs of the infection. The baby’s temperature and breathing rate will be checked every 4 hours. If the baby becomes unwell he/she will be given IV antibiotics also.
Symptoms to watch for after you go home
In the first few weeks at home if you notice any change in your baby’s behaviour that you are worried about, take the baby to see the family doctor or emergency department.
Signs that your baby is not well may include being very quiet and not feeding well or constantly crying without reason, baby may have a fever or be unable to stay warm, changes in breathing, rash or poor colour.
