In the last three decades, women in New Zealand, as in the rest of the Western world, have experienced escalating levels of intervention during childbirth and a declining ‘normal’ birth rate – the latter being recorded as 65.0% of all births in the Ministry of Health’s Maternity Tables 2013. As induction and/or augmentation of labour (51.1%), epidural anaesthesia (27.0%) and episiotomy (13.3%) are included in that rate, it is unknown how many women and babies actually experienced physiological labour and birth.
This Workshop embraces the facilitation of birth without unnecessary medical procedures. It actively promotes the restoration of physiological labour and birth as an ideal childbirth culture, and the time-honoured role of the midwife as a non-interventionist caregiver.
You will get most out of this workshop if you:
- Watch the Lecture movie below first as the context of the other components of the Worskhop are referred to in this. Please note, the ‘Leave a Reply’ at the bottom of this page replaces the Discussion Forums referred to in the Lectures.
- Take time to reflect on each of the resources and share your confusions and insights with others.
Movies applicable to this workshop
This 27 minute interview is with the late Marsden Wagner, perinatologist and perinatal epidemiologist who served as a Director of Maternal and Child Health for the California State Health Department, Director of the University of Copenhagen-UCLA Health Research Center, and Director of Women’s and Children’s Health for the World Health Organization. Filmed in 2010, it addresses many of the basic questions relating to the medicalisation of childbirth.
This 4 minute UNICEF movie featuring Shagufta Shahzadi, a community midwife in Pakistan, simply and effectively exemplifies many of the essential skills of the midwfe.
After watching this 6:45 minute move consider the challenges or opportunities to physiological birth in the environment in which you usually work. What changes, if any, are needed?
Podcasts applicable to this workshop
Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing. Declane Devane from the School of Nursing and Midwifery at the National University of Ireland compares the use of intermittent ausculataion and admission CTG in this 4:15 minute podcast.
Birth hormones. This hour long podcast is an interview with Dr Sarah Buckley on labour hormones. It is a resource aimed at women.
Lecture references and/or suggested readings
Alfirevic Z, Devane D, Gyte GML. (2013).Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD006066. DOI:10.1002/14651858.CD006066.pub2.
Begley CM, Gyte GML, Murphy DJ, et al. (2010). Active versus expectant management for women in the third stage of labour. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD007412. DOI:10.1002/14651858.CD007412.pub2.
Buckley S J. (2015). Hormonal physiology of childbearing: evidence and implications for women, babies, and maternity care. Washington, D.C.: Childbirth Connection Programs, National Partnership for Women & Families.
Cheng YW, Hopkins LM, Caughey AB. (2004). How long is too long: does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes? American Journal of Obstetrics and Gynecology, 191(3): 933‐938.
Downe S, Gyte GML, Dahlen HG, et al. (2013). Routine vaginal examinations for assessing progress of labour to improve outcomes for women and babies at term. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD010088. DOI:10.1002/14651858.CD010088.pub2.
Duff M. (1998). A journey in assessing labour progress. Book of Proceedings, New Zealand College of Midwives National Conference, Auckland, pp. 1‐13.
Gherman RB, Goodwin TM, Souter I, Neumann K, Ouzounian JO, Paul RH. (1997). The McRoberts’ maneuver for the alleviation of shoulder dystocia: how successful is it? American Journal of Obstetrics & Gynecology, 176(3): 656‐651.
Hiersch L, Melamed N, Rosen H, et al. (2014). New onset of meconium during labor versus primary meconium‐stained amniotic fluid – is there a difference in pregnancy outcome? The Journal of Maternal‐Fetal & Neonatal Medicine, 27:13:1361‐1367.
Hodnett ED, Downe S, Walsh D. (2012). Alternative versus conventional institutional settings for birth. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD000012. DOI: 10.1002/14651858.CD000012.pub4.
Miller S. (2008). First birth at home or in hospital in Aotearoa/New Zealand: intrapartum care midwifery care and related outcomes. Unpublished Masters thesis, Victoria University of Wellington: Wellington.
Muza S. (2012). The Wax home birth meta‐analysis: an outsider’s critique. Last accessed 23 February 2017.
Naaktgeboren C. (1989). The biology of childbirth. In: I Chalmers, M Enkin, MJNC Keirse. (1989). Effective care in pregnancy and childbirth. Volume 2: Childbirth. Parts VI‐X & Index. New York: University Oxford Press, pp. 795‐804.
Vain NE, Szyld EG, Prudent LM, et al. (2004). Oropharyngeal and nasopharyngeal suctioning of meconium‐stained neonates before delivery of their shoulders: multicentre, randomised controlled trial. The Lancet, 364(9434): 597‐602.
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