melbmidwifery.com.au
Syntocinon
Last Updated:03/04/2003
CLINICAL PHARMACOLOGY©
Active Ingredients: Oxytocin Injection
Representative Names: Oxytocin, Pitocin, Syntocinon
What is oxytocin injection?
OXYTOCIN (Pitocin®, Syntocinon®) is a natural hormone produced in the brain that causes the uterus to contract. Oxytocin can be used when labor needs to be induced or during labor if the contractions are not strong enough to progress normally. It is also used to control bleeding after childbirth. Oxytocin also can help to stimulate contractions if there is an incomplete abortion or miscarriage. Generic oxytocin injections are available.
What should my health care professional know before I receive
oxytocin?
They need to know if you have any of these conditions:
•breech, placenta previa, or other abnormal position of the fetus or umbilical cord
•cervical cancer
•eclampsia
•herpes infection
•more than 7 pregnancies
•premature delivery
•previous uterine surgery (including cesarean section)
•prolapsed uterus
•an unusual or allergic reaction to oxytocin, other medicines, foods, dyes, or preservatives
How should I use this medicine?
Oxytocin is for injection into a muscle or infusion into a vein. It is given by a health-care professional in a hospital or clinic setting where uterine contractions, mother's blood pressure and mother's and baby's heart rates can be monitored regularly, and where emergency measures can be taken immediately, if needed.
What if I miss a dose?
This does not apply.
What drug(s) may interact with oxytocin?
Oxytocin can interact with some other medicines. Your condition will be carefully monitored while you receive
oxytocin. Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What side effects may I notice from receiving oxytocin? Side effects with oxytocin are rare. Serious side effects with oxytocin include:
•chest pain or difficulty breathing
•confusion
•difficulty passing urine, sudden weight gain
•excessive or continuing vaginal bleeding
•fast or irregular heartbeat (palpitations)
•seizures (convulsions)
•severe or continuing headaches
•skin rash or itching (hives)
•unusual swelling
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
•irritation at the injection site
•nausea and vomiting
What should I watch for while taking oxytocin?
Your condition will be closely monitored while you receive oxytocin.
Where can I keep my medicine?
This medication is only given in a hospital or clinic. You will not keep this medicine at home.
New
mothers unhappy at care
Author:
Amanda Dunn, Health Reporter
Date: 24/08/2004
THE AGE
As
the time Victorian women spend in hospital after having a baby
continues to drop, a report shows they are increasingly unhappy
with the care they receive.
Experts
say this points to inadequate support once women return home with
their babies, and an imbalance of resourcing between care during
pregnancy and after birth.
Length
of stay and support after discharge are being reviewed by the State
Government. In Victoria, the average time a woman spends in hospital
after giving birth has decreased from 6.3 days in 1986 to 3.6 days in
2002, amid heated debate over the damage that might cause,
particularly to breastfeeding and postnatal depression rates.
The
report by La Trobe University's Mothers'
and Children's Health Research, published in the journal Paediatric
and Perinatal Epidemiology, reviews surveys of mothers
in 1989, 1994 and 2000.
Senior
researcher Stephanie Brown said the study found no significant link
between shorter stays and depression at five to six months after
birth. But a consistent pattern, Dr Brown said, was that women rated
postnatal care poorly. In the 2000 survey, only half the women
described their postnatal care as "very good", with 18 per
cent saying it was "poor" or "very poor".
"People
tend to assume that outcomes will be worse if women leave hospital
sooner, but that's predicated on an assumption that women are
receiving a high level of support while they're in the hospital,"
Dr Brown said. Support for new
mothers
after discharge from hospital - such as visits by midwives - was also
lacking, the survey found. Only half the women visited by midwives at
home found the visit helpful.
Leslie
Arnott, Victorian president of the Maternity Coalition, said she was
not surprised so many women found the experience inadequate, and that
she believed this was because they did not have the same midwife
through the birth and postnatal period.
Jeremy
Oats, an obstetrician at the Royal Women's Hospital and head of the
Government's maternity services advisory committee, said part of the
problem was that women often had little experience caring for babies
before having their own, and so needed more support early in the
child's life.
New
life for dirty nappies
By
Melissa Fyfe
Environment Reporter
September 1, 2004
Until
now, soiled disposable nappies were destined to spend about 500 years
in landfill before decomposing.
But
in an Australian first, a company launched in Melbourne yesterday will
take these smelly receptacles and turn them into cardboard boxes,
street signage, park benches, jetty planking and bollards.
MyPlanet
Recycling will deliver nappy wheelie bins - with inbuilt deodorant if
so desired - to parents in Bayside, Casey, Cardinia, Brimbank and the
Yarra Ranges council areas. For $7.60 a fortnight, the company will
empty the bins, taking the contents to its new plant in Noble Park.
The
nappies will then be processed through a giant washing machine, which
will send the contents to the sewer, and separate two (clean)
products: high quality wood pulp and plastic.
The
pulp will go to Amcor to make cardboard items, such as shoe boxes, and
the plastic to Repeat Plastics, for products used in parks and
streets.
MyPlanet
Recycling wants to eventually roll out its service to the rest of
Melbourne, taking 4000 tonnes of nappies each year. "Anybody in
Melbourne can sign up and we will get back to them with a start
date," said the company's community relations manager, Deborah
O'Dwyer.
She
said about 91 per cent of Australian parents chose disposables over
cloth nappies, resulting in 800 million nappies taking up 145,000
cubic metres of landfill each year.
Every
baby creates 845 kilograms of nappy waste before being toilet-trained,
said Environment Minister John Thwaites, launching the service
yesterday.
But
Environment Victoria said the new facility undermined the best green
choice: reusable cloth nappies washed by a professional service.
Disposables used 3.5 times more energy and 2.3 times more water to
make than reusable nappies. Cotton nappies do have drawbacks - water
and chemicals for washing, and landclearing to grow cotton crops. But,
says Jenny Henty, director of Environment Victoria's zero waste
campaign, they did come out more green in a lifecycle analysis.
"If
we want to make the best green choices we should be encouraging
parents to use cloth nappies," she said.
Website:
www.myplanet.com.au
Stress for newborns
could weaken immune system later in life
Public release
date: 30-Sep-2004
Contact: Mary Meagher
m-meagher@tamu.edu
Ryan A. Garcia
rag@univrel.tamu.edu
Texas A&M University
COLLEGE STATION, Sept. 30, 2004 -
Intense traumatic events, such as maternal separation, occurring early
in the life of an infant may weaken its immune system, making it more
susceptible to viral infections later in life that could trigger
multiple sclerosis, reveals research at Texas A&M University.
The research, by a psychologist Mary
Meagher from the College of Liberal Arts and an immunologist Jane
Welsh from the College of Veterinary Medicine at Texas A&M, shows
that exposure to prolonged maternal separation during the first two
weeks of life altered immune, endocrine and behavioral responses to
acute "Theiler's virus" infection in mice.
Theiler's virus attacks the central
nervous system during the first few weeks of infection, which is
accompanied by polio-like symptoms. If the virus persists in the
central nervous system, a subsequent chronic phase of the disease
develops which is similar to multiple sclerosis in humans.
Researchers use Theiler's virus to
investigate the role of stress in autoimmune diseases, or diseases
that cause the body to attack its own cells as if they were foreign
pathogens - a similar process occurs in multiple sclerosis, Meagher
explains.
In this study, infant mice that were
subjected to maternal separation and later contracted Theiler's virus
as adults demonstrated an increased amount of the virus, altered
behavioral signs of infection and had a more difficult time getting
over, or "clearing," the infection in its acute stage than
did mice that were not separated from their mothers and later
contracted the disease.
Such results, Meagher explains,
suggest that the immune system is undergoing a critical period of
development early in an organism's life, and that a considerable
stressor can cause significant life-long alterations to the immune
system that increase its vulnerability to diseases of the central
nervous system later in life.
Previous studies have shown stress to
play an important role in the contracting of multiple sclerosis in
humans, finding that 80 percent of adults who contract the disease
reported a stressful life event two years before its onset. Meagher's
research takes that exploration a step further, examining how early
life stress alters vulnerability to later viral infections of the
central nervous system.
Her research is being conducted as
part of the "Recovery of Function" program, a new
interdisciplinary program that enrolls about 30 graduate students and
is composed of 14 faculty members from seven departments in four
colleges at Texas A&M - the Colleges of Liberal Arts, Veterinary
Medicine, Agriculture and Life Sciences, and Medicine. The program
focuses on research interests such as the loss and recovery of neural
function following injury, infection, aging and neurodegenerative
disease in laboratory animal models. In addition, the program is
affiliated with several off-campus research centers in Houston,
Galveston and Dallas that focus on both laboratory and clinical
research.
Understanding how early stress
affects the developing immune system could lead to interventions that
prevent or reverse the harmful effects of newborn stress on disease
predisposition, Meagher says. Some treatments could possibly include
antidepressants and/or teaching coping mechanisms for individuals who
are more likely to be susceptible to the disease, she adds.
Australia's first milk bank
August 12, 2004 - 1:06PM - AAP
Australia's first milk bank is to start offering breast milk to new
mothers in Victoria from the beginning of next year.
Melbourne-based lactation consultant Margaret Callaghan plans to open the private service which will pasteurise milk donations and offer them
to mothers who cannot produce enough for their own babies.
The proposal has raised questions about how the new service would be regulated.
Ms Callaghan said the private company setting up the Victorian milk bank
planned to set up in NSW next and then to establish clinics nationwide.
She said new mothers who wanted to donate would be screened for disease
and would then express the milk at home.
"It wouldn't be like a cow shed," she said.
The milk would be pasteurised and given to premature babies whose mothers for some reason could not provide enough milk.
Premature babies would be targeted initially as they were the most likely to suffer necrotising enterocolitis (NEC), or bowel blockages,
after being fed formula, she said.
Mothers milk also aided neurological development and reduced the risks
of infections, Ms Callaghan said.
Hospitals used to provide excess milk from new mothers to babies who needed it until the rise of the spectre of AIDS in the 80s.
Ms Callaghan said that as the average age of mothers increased, so had
the demand for breast milk.
"I have people ringing me saying 'Where can I get some human milk from'," she said.
The president of paediatrics and child health of the Royal Australasian
College of Physicians, Professor Don Roberton today said any move to make breast milk more available was positive as long as the milk was
properly screened for disease.
Professor Roberton said human milk had advantages over formula, especially for premature babies.
"But we also have to be very aware of any potential risks that might occur with human milk," he said.
Breast milk would need to be carefully screened in the same way donated
blood was, he said.
Breast milk banks operate in the UK, the USA and parts of Europe but the
prospect of them opening in Australia has raised the question of who is
responsible for their regulation.
A Therapeutic Goods Administration spokesman said a breast milk bank would be a state rather than a federal responsibility.
A spokesman for the Victorian Department of Human Services said a breast
milk bank would come under the State food act.
The operators would have to show their product was "free of infection and fit for human consumption" and convince the government that they had
strict screening processes in place, he said.
Letter to the Editor
High-tech bid to quench athletes' thirst
“Australian Olympians have a better chance at quenching their thirst for gold thanks to our sports scientists' development of new hydration techniques”.
I am particularly interested in this article – in relation to the effects of dehydration occurring with women during labour.
As an independent midwife practitioner, I provide care for women on a 1-2-1 basis during pregnancy, labour, birth and up to four weeks afterwards. For some years now I have recommended sipping Gastrolite Rehydration Fluid during labour. Women who are well hydrated orally with a balance of glucose and salt, rarely experience the effects of dehydration, even during a protracted labour. Nausea and vomitting is also rare for these women. It would be interesting to talk to the scientists working on the project to compare the differences and similarities of the metabolic state of elite athletes and labouring women.
Thanking you for the opportunity to comment
Robyn Thompson
Midwife Practitioner
To cut or not: debate on childbirth procedure
By Amanda Dunn
Health Reporter
August 13, 2004
A surgical cut to make room for the baby's head in a vaginal birth is too commonly performed in private Victorian hospitals, an obstetric expert has warned.
Obstetric epidemiologist James King also told The Age that, conversely, severe vaginal tears during childbirth are more prevalent in public hospitals, which may indicate the need for better supervision of inexperienced doctors.
"Sometimes it (cutting) is absolutely necessary, but it's probably overused," he said.
His comments followed a report commissioned by the Department of Human Services, which found that between 1999 and 2002, an episiotomy - in which an incision is made through the perineum at the entrance to the vagina - was given to one in every three private patients, compared with one in five public patients.
The issue has long been a controversial one in maternity circles, with little agreement on the relative benefits of cutting versus tearing.
Professor King, who led the review, said the difference between public and private rates may be because vaginal deliveries were more likely to be supervised by midwives in the public system, who supported lower episiotomy rates.
In contrast, births in the private system were supervised by obstetricians who may be slower to take up the most recent evidence on
episiotomy.
The report also found that the most severe lacerations, which can tear through to the anus, damaging muscles and causing long-term incontinence, occurred for 16 in every 1000 public patients, and 11 in every 1000 private patients.
"It may be that there's a requirement for more supervision of these individual deliveries," Professor King said.
Episiotomy and severe lacerations were far more common when forceps were used than the vacuum extraction during the birth, he said, and were also higher for women having their first babies.
Euan Wallace, an obstetrician at Monash Medical Centre, said it was once the orthodox view that episiotomy was preferable to allowing a vaginal tear because it preserved pelvic floor muscles. But evidence since has challenged that view.
"It's quite clear now that in terms of long-term health it's much better to tear than it is to cut," Professor Wallace said.
He believed that some severe lacerations were probably unavoidable, but there was also a small number of cases when an episiotomy could reduce that risk.
Shane Higgins, director of delivery suites at the Royal Women's Hospital, agreed that registrars and midwives needed to be better supervised to reduce severe tears, but there was likely to be more than one reason for the difference in the rates.
Leslie Arnott, Victorian president of the Maternity Coalition, said episiotomy rates were another example of too much intervention in childbirth, and would be reduced by better access to one-to-one midwifery.
She said severe tears would also be reduced by better supervision of doctors and more willingness to allow natural childbirth to occur rather than trying to hurry it.
Kate Duncan, a private obstetrician and Victorian vice-president of the Australian Medical Association, said it was difficult to judge whether episiotomy rates were too high, as the ideal rate was unknown.
Maternity
services to get overhaul
By
Amanda Dunn
Health Reporter
June 22, 2004
Maternity
services in Victorian public hospitals are to be overhauled, with the
State Government improving team-based midwifery care to run alongside
obstetric services.
The
new model, to be announced today, will encourage more women with
low-risk pregnancies to have their babies using midwives rather than
obstetricians. If complications arise, the woman would be transferred
to the obstetric care stream, although in some cases this may not be
located at the same hospital.
Health
Minister Bronwyn Pike said the main reason for the change was that
many women sought the option. But she also acknowledged that the
shortage of obstetricians and anaesthetists was part of the equation.
"Certainly workforce is an issue, but it's not the driving force
for this," she said.
Ms
Pike was concerned by rising levels of intervention in childbirth,
particularly by elective caesarean section.
"I'm
worried about the plethora of stories in women's magazines that seem
to indicate that women are choosing a caesarean section, when it's not
medically required, for cosmetic reasons," she said.
Elective
caesarean rates in Victoria have jumped from 11.5 per cent of births
in 1999 to 14.1 per cent in 2002. In public hospitals in 2002, 11.6
per cent of births were by elective caesarean, and 63 per cent of
babies were born in public hospitals.
For
most hospitals that chose to adopt the new model, she said, the
obstetric and midwifery services would be at the same location.
"There
will be, however, the opportunity for some services which have good
access to a tertiary service to offer only the midwifery model of
care," she said.
One
of those earmarked for this model would be Williamstown Hospital,
where women who developed complications would be transferred to
Sunshine Hospital for obstetric care.
Jeremy
Oats, chairman of the maternity services advisory committee and
director of women's services at the Royal Women's Hospital, said
details had yet to be finalised. "What we need to make sure is
that it can deliver safe, optimal outcomes for women who choose that
model of care," Professor Oats said.
He
believed the benefits of the new system would be in best using the
skills available - obstetricians and midwives.
But
there is also a shortage of midwives, and the profession is ageing,
which could be a problem. As part of the changes, the Government has
allocated $450,000 for training doctors and midwives for the new
system.
Professor
Oats said rural services, which have been struggling under closures of
maternity units, would also benefit from the new system, allowing GPs
with obstetric skills and midwives to improve their expertise.
Opposition
health spokesman David Davis supported midwifery care, but he accused
the Government of using the new model as "a cover for further
cuts and closure in maternity across Victoria".
Since
1993, 27 hospitals have ended their obstetrics services. But Ms Pike
said the new model meant maternity services were more likely to stay
open, protecting them from closure because of a shortage of
specialists.
Birthing pools ease
need for pain relief
By
Ruth Pollard, Health Reporter
January 27, 2004
Women
were less likely to need pain relief during labour if they used a
birthing pool, British researchers have found.
Experts
say the findings, published on the British Medical Journal
website, could influence Australian practice, where only a small
number of childbirths occur in water.
Comparing
99 first-time mothers experiencing slow progress in labour, half were
immersed in a birthing pool during the first stage of labour.
Of
the 49 women in the water group, half needed an epidural, compared
with two-thirds of the 50 women in the other group, the researchers
from Southampton University found.
It
also found immersion in water helped to relieve pain and anxiety and
reduced the need for medical intervention or drugs to aid their
contractions.
The
head of policy research at Britain's National Childbirth Trust, Mary
Newburn, said the results emphasised the importance of providing
birthing pools in all public maternity units.
However,
some experts were concerned water births might increase the risks to
the baby.
Kat
El Karout, clinical nurse specialist in the birth centre at the Royal
Hospital for Women and Children, told the Herald birthing in a
pool was not commonplace in Australia.
"Women
have to come to a specialised birth unit to even have it as an option
in Australia," Mrs El Karout said. The practice of putting women
in water when their labour had slowed was also very different to
Australian practice, which involved taking women out of the water and
having them walk around, she said.
The
study's results were enough to make practitioners at the Royal Women's
consider a change in practice, Mrs El Karout said. "It is based
on a small sample of women, but it would make us think again about the
way to best manage a slow labour."
A
high percentage of women who attended the Royal Women's hospital birth
centre chose water birth - 41 per cent - and up to 80 per cent of
those who gave birth at the hospital used water at some stage during
their labour for pain relief, Mrs El Karout said.
"It
is a spiral with intervention, so if you can reduce even getting onto
that slippery slope then you increase the chance of having a normal
birth with no intervention," she said.
"Women feel more
in control in the water, there is less need for pain relief and [it
is] easier for the baby."
How
to avoid a Caesarean: take along a female friend for the support the
father cannot provide
By Jeremy
Laurance Health Editor
24 September 2003
Allowing men into the delivery room has been one of
the great social transformations of our time. Four out of five births
are now attended by the baby's father; but nobody has thought to ask
whether their presence is helpful.
Mothers are discovering the secret of a good birth is having another
woman present. The loss of female support in childbirth and its
replacement by men could lie behind the soaring Caesarean rate, which
has doubled in 20 years.
A review of 15 research trials involving almost 13,000 women published
in the Cochrane Library, the biggest source of evidence-based health
care in the world, has demonstrated a female supporter is the best
guarantee of a natural birth.
Mothers who had continuous support throughout labour from a woman
trained to give it needed less pain relief, had fewer
"operative" births - Caesareans or forceps deliveries - and
had a more positive experience than those who received the normal
attention of an often overworked midwife.
Professor Elaine Hodnett, of Toronto University, who ran the review,
said the presence of a trained supporter who was not employed by the
hospital and whose only loyalty was to the woman in her care was a
"very powerful" element.
"My bottom line is women need and deserve close and continuous
support in labour in an environment that is supportive. Many midwives
will tell you they don't have the time to provide that. The key is the
relationship the carer has to the woman. The evidence showed if
continuous support was provided by a nurse or midwife it was less
effective," she said.
The idea is hardly new. Until 50 years ago, women typically gave birth
supported by other women throughout labour, and had done so since the
dawn of time. A mother, sister or neighbour would provide comfort and
assist the woman through one of the most emotionally and physically
demanding experiences of her life.
But from the middle of the 20th century, as doctors assumed control of
childbirth and it moved from home to hospital, the tradition of
providing continuous support to women in labour was lost. Birth became
technology driven. In place of the soothing presence of mother, sister
or neighbour came the foetal monitor (to check the baby's heartbeat)
with its blinking lights and nervy alarms.
The dehumanisation of birth in the past half century has provoked one
of the biggest protest movements in medicine. Women have sought to
wrest control from the doctors and ensure labour and childbirth follow
a natural course rather than one determined by technical requirements.
But it has been a losing battle. The rate of interventions in
childbirth - involving induction of labour, anaesthesia, forceps
delivery or Caesarean - has risen inexorably. Figures published by the
Department of Health in May showed that "normal" childbirth
- without any intervention - has for the first time become a minority
activity in Britain. Fewer than half of all new mothers - 45 per cent
- now have a spontaneous labour and delivery.
The trend has not curbed the demand for natural childbirth and now
women are learning that hiring a female supporter may be the most
effective way of obtaining it. The idea of providing expectant mothers
with a woman trained to support her has been imported from the US,
where maternity care is even more technology-based and less woman-centred
than in the UK. The female supporters are called "doulas" -
from the Greek for "servant" - and there are an estimated
35,000 doulas assisting women in the US to challenge the technological
tyranny of the medical birth. In Britain, there are only a few doulas
practising today but demand is rising.
Doulas are not medically qualified but they have training ranging from
a few days to nine months, depending on their previous experience.
Importantly, they are hired by the woman, not the hospital, to support
her through labour, provide encouragement and praise as well as coping
techniques and to represent the mother's wishes to medical staff.
They bring the voice of experience to a situation which, for new
mothers in particular, may seem frightening or threatening. And,
rather than undermining the role of husbands and partners, they may
turn out to support them too. Anecdotal evidence suggests men welcome
the presence of someone with experience who relieves them of
responsibility, eases their anxiety and helps them to play their part
in the birth experience.
In Britain, doulas charge from £250 to £500 to attend a birth, which
may last from a few hours to more than once round the clock. In the
US, the value of doulas has been accepted by private medical insurers,
which will include covering their fees in recognition of their role in
promoting natural birth and reducing the costs of Caesareans and
similar interventions, as well as the risk of a negligence case if
things go wrong.
But the cost of hiring a doula, and the need for the hirer to be the
expectant mother and not the hospital or health service, puts them
beyond the reach of most women. In North America, trials have been run
with volunteer doulas whose services are offered to the neediest.
"They have been successful - but it is a lot to ask," said
Professor Hodnett.
Mary Newburn, the policy director at the National Childbirth Trust,
said the Cochrane Review was "an absolute gem" and its
findings "very important." She said: "It shows very
clearly that one of the most effective things you can do to improve
outcomes is provide women with continuous support during labour. It is
extraordinarily effective in reducing Caesareans, the need for pain
relief and even how mothers relate to their babies after birth. It is
one of the few interventions with hard evidence to show its
benefit."
That view was backed by obstetricians who did a study at Derriford
Hospital, Plymouth in which 20 women were filmed throughout the course
of their pregnancies and labours to record how many staff attended
them and what they did. The number of staff who cared for the women
ranged from three to 11 and the midwives were seen to be spending more
time filling in forms than sitting with mothers and talking to them.
The study, led by Keith Greene, consultant gynaecologist and director
of perinatal research at the hospital, concluded the demands on
midwives to provide technically exemplary care, record it meticulously
and give emotional support all at the same time were incompatible.Loss
of confidence in the care may have contributed to the rise in
Caesareans, the study said.
The researchers appealed for greater recognition for the doula, whose
role in promoting a good birth now seems to be beyond doubt. In their
conclusioin, they said: "It seems an irony that the most
effective intervention, continuous female support in labour, receives
little public support and low institutional priority, perhaps because
it is not perceived as sophisticated enough, or too simplistic to
merit a high profile."
'She was amazing. We call her our
angel'
Naomi Golding wanted a natural birth. She didn't want drugs, or
medical interventions, and she was not too posh to push. She had never
heard the term "doula", but when she met Jo Sweeney, she
hired her. Having an experienced woman to help her through labour
seemed the best way of achieving a good birth.
"The support she gave me was incredible. She talked to me all
through labour, rubbed my back to ease the pain, and gave me advice.
It was amazing to have her there. We call her our angel."
Mrs Golding, 30, delivered her daughter, Ciara, at Queen Charlotte's
hospital, west London, without medical assistance or painkilling
drugs. Her husband, Ian, a management consultant, was with her
throughout, alongside Ms Sweeney.
"On the day I went in, it was extremely busy and the midwives
were all over the place. We were left for two hours without anyone
attending us. We would have panicked without Jo.Hospitals have their
own agendas. Having someone there to stick up for you makes all the
difference."
Ms Sweeney, who has worked as doula for four years, charges £400 and
is on call for two weeks before and after her client's expected
delivery date. She will be with her throughout labour and birth.
"The longest labour I have helped was 14 hours. I don't do
anything medical but I am passionate about the idea that women can do
it for themselves. All they need is support," she said
Perfumes linked
to infertility, cancer
From The Sunday
Times's Lois Rogers
November 25, 2002
The Australian
HIGH levels of a
chemical blamed for causing infertility in men have been found in some
of the world's best-known perfumes and cosmetics.
Chanel No5,
Christian Dior's Poison, Eternity from Calvin Klein and Tresor by
Lancome were among 34 toiletries found by a Swedish study to contain
di-ethylhexyl phthalate or other phthalates.
The European
Commission is proposing a ban on the use in cosmetics of two of the
most potent forms of phthalates amid fears they cause genital
abnormalities affecting up to 4 per cent of male babies.
These genital
abnormalities - which can include undescended testicles and
malformation of the urinary tract - are blamed for soaring levels of
testicular cancer in young men. Cases of the disease have risen
tenfold in the past century. About 1900 British males, some as young
as 15, are diagnosed every year. Nine out of 10 cases are cured, but
doctors are worried by the trend.
Scientists believe
the phthalates could be absorbed into women's bloodstreams through the
skin or inhalation.
The Cosmetic
Toiletry and Perfumery Association condemned the report as inaccurate.
It said: "Consumer safety is the first priority for the cosmetic
industry and consumers can have complete confidence in the cosmetic
products they use, and in the regulatory framework which ensures
cosmetic safety."
Numerous studies on
rats and mice have shown phthalate exposure causes genital
abnormality. The latest research was conducted by a Swedish
government-accredited laboratory for Healthcare Without Harm, a
US-based organisation representing 300 consumer pressure groups around
the world.
Researchers at the
Analycen lab analysed 34 leading brands of cosmetics and found more
than three-quarters contained phthalates, which help prevent loss of
fragrance.
The investigation
found other forms of the chemical in Tommy Girl perfume, Impulse Body
Spray, Nivea Deo Compact, Sure Ultra deodorant, Shockwaves hair mousse
and four hairsprays including Elnett Satin, Pantene Pro-V Extra Hold
and Vidal Sassoon.
Per Rosander, who
wrote the report, said: "What we know about these chemicals is
that they cause damage to the reproductive system. That is why they
have been classed by the EU as reproductive toxins."
Richard Sharpe, of
the Medical Research Council's Human Reproductive Sciences Unit in
Edinburgh, said: "If you wanted to produce a list of
environmental causes of the reproductive health problems in boys,
phthalates would be pretty near the top of the list."
Actor Julia Sawalha,
who played Saffy in Absolutely Fabulous, supports the Women's
Environmental Network, a backer of the Swedish research.
"Chemicals that pose a risk to fertility do not belong in
cosmetics, and manufacturers should be made to list ingredients,"
she said.
Call for natural births
13 October 2002 The Sunday-Herald Sun
The use of surgical procedures and drugs in childbirth was now so common that many women were doubting their ability to give birth naturally, an expert said yesterday.
Professor Kathleen Fay, from the University of Newcastle, said medical intervention in the birthing process had soared.
"Only 25 per cent of first time mothers in Australia have what is considered to be a fully normal birth," she said.
"This is quite ludicrous when never before in our history have we had such a health group of young women."
Professor Fahy advocated a model of care that made midwives, not obstetricians, the primary care givers throughout pregnancy, labour and birth.
Obstetricians should only be involved in a birthing when there was a demonstrated need, she said.
"Babies will be no worse off, and mums will definitely be better off because there is less damage to their bodies," she said.
Rare Form of Breast Cancer –
Paget’s Disease
In
November, I lost my sister to a rare kind of breast cancer. She
developed a rash on her breast, similar to that of young mothers who
are nursing. Because her mammogram had been clear, the doctor treated
her with antibiotics for infections. After 2 rounds and it continued
to get worse, her doctor sent her for another mammogram, and this time
it showed a mass. A biopsy found a fast growing malignancy. Chemo was
started in order to shrink the growth; then mastectomy; then a full
round of chemo; then radiation. After about 9 months of intense
treatment, she was given a clean bill of health. One year of living
each day to its fullest – then it returned to the liver area. She
took 4 treatments and decided that she wanted quality of life not the
after effects of chemo. We had 5 great months and she planned each
detail of the final days. After just a few days of needing morphine,
she slipped away saying she had done what God had sent her into the
world to do and now it was her time to go.
I still have tears as
I write, but her message is shown below. And PLEASE be alert to any
thing that is not normal and be persistent in getting help as soon as
possible.
RARE FORM OF BREAST
CANCER – PAGET’s DISEASE
{ from Juanita Bush }
This is a rare form
of breast cancer and is on the outside of the breast, on the nipple
and aureole. It appeared as a rash which later became a lesion with a
crusty outer edge. I would not have ever suspected it to be breast
cancer but it was. My nipple never seemed any different to me but the
rash bothered me, so I went to the doctor for that. Sometimes it
itched and was sore, but other than that it didn’t bother me. It was
just ugly and a nuisance and could not be cleared up with all the
creams prescribed by my doctor and dermatologist for the dermatitis on
my eyes just prior to this outbreak. They seemed a little concerned
but did not warn me it could be cancerous. Now I suspect there are not
many women out there who know a lesion or rash on the nipple or
aureole can be breast cancer. Mine started out as a single red pimple
on the aureole. One of the biggest problems with Paget’s disease of
the nipple is that the symptoms appear to be harmless. It is
frequently thought to be a skin inflammation or infection, leading to
unfortunate delays in detection and care. What are the symptoms? The
symptoms include :
A persistent redness, oozing, and
crusting of your nipple causing it to itch and Burn. (As I stated,
mine did not itch or burn much, and had no oozing I was aware of, but
it did have a crust along the outer edge on one side).
(2) A sore on your
nipple that will not heal. (Mine was on the aureole area with a
whitish thick looking area in center of nipple).
(3) Usually only
one nipple is affected.
How is it diagnosed?
Your doctor will do a
physical exam and should suggest having a mammogram of both breasts,
done immediately. Even though the redness, oozing and crusting closely
resemble dermatitis (inflammation of the skin), your doctor should
suspect cancer if the sore is only on one breast. Your doctor should
order a biopsy of your sore to confirm what is going on. They will
take a sample of your breast tissue in that area to test for cancer.
If the cancer is only in the nipple and not in the breast, your doctor
may recommend just removing the nipple and surrounding tissue or
suggest radiation treatments. Had my doctor caught mine right away
instead of flaking it off as dermatitis, perhaps they could have saved
my breast and it wouldn’t have gone to my lymph nodes.
This message should be taken
seriously and passed on to as many of your friends as possible; it
could save someone’s life. My breast cancer has spread and
metastasized to my bones after receiving mega doses of chemotherapy,
28 treatments of radiation and taking tamaxofin. If this had been
diagnosed as breast cancer in the beginning, perhaps it would not have
spread.
Explanation: In 1874, Sir James Paget described a chronic inflammation of the skin
around the nipple. The skin eruption resembles eczema and the symptoms
include tenderness, itching, burning, and intermittent bleeding. Paget's
disease of the breast is not common (only about two percent of all breast cancers), but it is important because it appears innocuous. It is
frequently diagnosed and treated as dermatitis or bacterial infection,
leading to an unfortunate delay in detection. When the symptoms consist of nipple changes only, the likelihood that
the cancer has spread to the lymph nodes in the armpit is about five percent. However, Paget's disease is almost always associated with
either an underlying cancer within the milk ducts of the breast or an invasive tumor of the breast tissue
itself. In these cases, the symptoms typically include an encrusted, scaly, red sore on the nipple or areola
(the pink area around the nipple) that will not heal. During physical examination of the breast, the patient or doctor may also be
able to feel a lump or mass in the tissue beneath the nipple. In general, patients with this form of breast cancer have a better
prognosis than the majority of breast cancers because the obvious changes in the nipple and areola promote a visit to the
doctor sooner rather than later. Early consultation with a doctor, biopsy, and
diagnosis, including a mammogram, lead to early treatment. Diagnosis and treatment of Paget's disease
Diagnosis begins with both a mammogram and a biopsy, during which a small tissue sample is taken from
the suspicious area of the nipple. The tissue is examined under a microscope for
the presence of cancer cells. Treatment varies somewhat, depending on the type of carcinoma.
If cancer cells are identified in the biopsy, and if a lump is also palpable beneath
the nipple or in the deeper breast tissue, the treatment is relatively straightforward. The surgeon will probably
recommend a lumpectomy, which removes the nipple, areola, and lump. If,
however, there is no associated palpable lump and if there are no obvious abnormalities on the mammogram,
the surgeon will remove only the nipple complex. Whole breast radiation therapy is recommended following
surgery to eradicate any remaining cancer cells within the intact breast.
Lymphatic mapping and sentinel node biopsy The lumpectomy is often combined with a new technique to obtain information
regarding spread of the cancer to the lymph nodes in the armpit. In the past, to obtain
information about the status of the lymph nodes, the surgery removed the
entire contents of the armpit (called a complete lymph node dissection).
This procedure required a significant recovery time had a number of associated risks including fluid collection underneath the skin,
infection, swelling of the arm, and nerve damage. Now, a much newer technique, sentinel lymph node mapping, eliminates these risks.
Available at Cayuga Medical Center, lymphatic mapping with sentinel node
biopsy identifies the first node into which lymph fluid from the tumor
drains. This sentinel node has been found to be the most likely to contain spreading cancer cells. Considered state-of-the-art management
for melanoma, this technique had been shown to be predictive of the status of remaining lymph nodes and has eliminated the need to perform a
complete lymph node dissection. Sentinel lymph node biopsy has become valuable in the treatment of breast cancer.
The removal of a solitary lymph node is much less invasive, dramatically
decreases patient discomfort and complications, and allows for an increase in the accuracy of finding metastatic cancer. Instead of
producing one microscopic slide for each of 30 to 40 lymph nodes, the pathologist can thoroughly examine several slides of just one node,
allowing small metastases within the lymph node to be found.
Depending on the size and type of primary tumor and the status of the lymph node, the patient may then undergo some form of adjuvant therapy.
This may take the form of radiation therapy, chemotherapy, or a combination of the two.
Source: Cayuga
Medical Center
Return
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Smoke link to
infant mortality
By ROBYN RILEY, Medical reporter
05may02 The Sunday-Herald Sun
PASSIVE smoking has been linked to the deaths
of 23 Australian children.
A
study found passive smoking was a contributing cause of death for the
children, who were all aged under one.
It was also a trigger for thousands
of children suffering life-threatening illness.
The report, by the Australian
Institute of Health and Welfare, said the 23 children died from Sudden
Infant Death Syndrome, but that passive smoking was also linked to
their deaths.
Report co-author Chris Stevenson said
the figure was an "under-estimate"; that there could be many
more.
"But, of course, passive smoking
is a problem everywhere so we know we have under-estimated the number
of deaths, we just don't know by how many," Mr Stevenson said.
In the institute's report, released
last year, passive smoking was linked to 1428 children needing
hospitalisation. Many were suffering from asthma attacks, but others
were also seriously ill with respiratory disease.
The report concluded: "The
weight of evidence suggests that exposure to environmental tobacco
smoke is associated with asthma in children."
The National Health & Medical
Research Council agrees. It says thousands of Australian children have
asthma, and in many cases it can be linked to passive smoking.
The NHMRC also said passive smoking
was linked to croup, bronchitis and pneumonia in children, and that
babies exposed to tobacco smoke are 60 per cent more likely to suffer
respiratory problems.
The NHMRC says passive smoking can be
deadly to children.
In 1997 it released a major report
that revealed:
CHILDREN exposed to tobacco smoke are
almost twice as likely to suffer from asthma.
PASSIVE smoking contributes to the
symptoms of asthma in 46,500 Australian children a year and is linked
to lower respiratory illness in 16,300 Australian children.
IT AGGRAVATES pre-existing asthma in
children.
EVERY year thousands of Australian
children are hospitalised for asthma, at times triggered by passive
smoking.
THE RISK of lower respiratory
illnesses, such as croup, bronchitis and pneumonia, is about 60 per
cent higher in children exposed to tobacco smoke during the first 18
months of life.
MOTHERS who smoke during pregnancy
increase a baby's risk to SIDS.
Dr Rob Roseby, a pediatrician at the
Royal Children's Hospital in Melbourne, saids it was no good beating
parents about the head with dire warnings. "I have surveyed a
group of Victorian parents who smoke and 80 per cent know it is bad
for their children," Dr Roseby said.
"Of the parents we interviewed,
76 per cent want to quit smoking and 14 per cent are thinking about
it."
But Dr Roseby said the issue must be
treated carefully and sensitively.
Return
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New age for cry
babies
By Anna Patty
The Herald Sun -
March 26th, 2002
Babies from as
young as a few weeks old are being treated with acupuncture
needles, massage therapy, chiropractic techniques and herbal
remedies.
Their parents are increasingly turning to
natural therapists and yoga teachers to help settle crying
babies affected by conditions including colic, colds, teething
pain and digestive problems.
But doctors yesterday
warned parents to be cautious and urged them to first see a GP
to eliminate any serious cause behind a baby's distress.
Federal AMA president Kerryn Phelps said while there was
evidence to suggest massage could help settle babies without
an underlying medical condition, many other treatments were
scientifically unproven.
"I'd offer a note of
caution to parents," Dr Phelps said.
"First stop must always be to a GP or pediatrician to
rule out any possible medical cause of the baby's
symptoms."
Professor Kim Oates, chief executive
at Sydney's Children's Hospital, Westmead, said many childhood
conditions, such as colic, improved spontaneously with time.
|
Treatment
Types
ACUPUNCTURE: used to treat
respiratory problems, coughes and cold, earache, teething
pain, constipation and digestive problems. Fine needles are
inserted and immediately removed from the baby's skin as a key
pressure point to unblock energy. (Adults keep needles
inserted for up to 30 minutes).
SHIATSU: a Japanese
massage incorporating hand or elbow pressure on specific
points in the body to unblock energy channels called
meridians. It is commonly used to treat babies for
colic, ear infections, colds and flue and respiratory
problems.
YOGA: while babies naturally perform
yoga on their own, helping them form various positions is
believed to help them develop flexibility and healthy bones
and organs.
CHIROPRACTIC: chiropractors gently
loosen joints in baby spinal columns to treat problems such as
colic.
OSTEOPATHY: used to treat feeding and
digestive problems, colic, allergies, respiratory problems,
nerve and structural abnormalities. It involves gentle
adjustments to the musculoskeletal system to improve
structural balance.
BOWEN: a form of massage
that involves gently rolling thumbs and fingers over muscles,
tendons and ligaments to improve relaxation, release tight
muscles and improve joint mobility. It is used to treat
colic, respiratory problems, constipation, irritability and
sleeping difficulties. |
The
facts for new parents
Q.
Why are parents turning to natural therapies to treat babies?
A:
Parents say they help treat complaints including colic and
irritability when a medical cause cannot be found.
Drug-free, non-interventional treatments are increasingly
being sought as alternatives to medical treatments.
Q:
What type of motors are using natural therapies for their
children?
A: Mostly mothers who have used the same
therapies during their pregnancies who seek similar modes of
treatment for their babies.
Q: Are there any age
restrictions?
A: Depending on the particular technique,
babies are being treated from as early as a few weeks old.
Q:
What type of alternative therapies are being used to treat
babies?
A: Acupuncture, shiatsu, Bown technique,
osteopathy, chiropractic treatment, herbal medicine, massage
and yoga.
Q: Is it safe?
A: Doctors and
natural therapists agree baby massage is safe and effective,
but there is debate over the use of other alternative
therapies for babies. Doctors wan that small children
should be taken to a GP or pediatrician as a first port of
call to ensure a serious illness, such as meningococcal
disease or gastrointestinal problems, are not the underlying
cause of the baby's irritability. Parent who have checked for
medical reasons and found none say they often find natural
therapies performed by qualified practitioners help settle
their babies.
|
"That's
why some people swear by unorthodox treatments, because the
children get better anyway," he said.
"Massage is effective because it is good for babies to be
touched and stimulated and close to their parents.
"But an irritable baby many have meningitis, an infection
in the body or gastrointestinal condition where any delay of
appropriate medical treatment can be dangerous."
Natural therapists say parents mostly seek their help when
traditional medicine has failed to find a reason for their
child's crying.
Shiatsu therapists Anne McDermott,
past president of the Shiatsu Therapy Association of
Australia, said the gentle massage and pressure technique was
mostly used to treat babies for cold, flu and constipation.
"It's becoming more popular to treat babies," she
said.
Shiatsu therapists Claire Cleaver, from the
Glebe healing Centre in Sydney, said mothers who had already
tried treatments for themselves most commonly brought their
babies in for shiatsu. "It helps them to settle and
feed better," she said.
Acupuncturist Ngaio
Richards said parents were increasingly seeking drug-free
treatments for their children. "We can treat babies
from a few weeks of age for things like digestive
problems," she said.
Gill McKinlay said her
eight-month-old daughter Lily Bean had received acupuncture
for cold and constipation. "I've been getting
acupuncture regularly since I was five months pregnant,"
she said.
Osteopath Colleen Kent, from the Glebe
Healing Centre, said her work complemented that of a
pediatrician. "We can help ease or assist problems
diagnosed by a pediatrician," she said.
Shanti Steiner, from Yoga Warehouse, said her five-month-old
daughter Tarabella Israel could do a half-lotus
position. "It's good for the hips, knees and
digestive system," she said. "Starting your
baby at a young age will help them develop healthy bones and
flexibility which is good for their internal organs."
Return
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|
The ultrasound danger from out of left field
By Robert Matthews and Julie Robotham
The Sydney Morning Herald - Monday, December 10,
2001
Evidence suggesting that ultrasound scans on
pregnant women cause brain damage in their unborn babies has been
uncovered by scientists.
In the most comprehensive study yet on the effect of
the scanning, doctors have found that men born to mothers who
underwent scanning were more likely to show signs of subtle brain
damage.
During the 1990s, studies suggested subtle brain
damage from ultrasound can cause people who ought genetically to be
right-handed to become left-handed. In addition, they face a higher
risk of conditions ranging from learning difficulties to epilepsy.
Now a team of Swedish scientists has confirmed the
earlier reports.
It compared almost 7000 men whose mothers underwent
scanning in the 1970s with 170,000 men whose mothers did not. The team
found that men whose mothers had scans were significantly more likely
to be left-handed than normal, pointing to a higher rate of brain
damage while in the womb.
Crucially, the biggest difference was found among
those born after 1975, when doctors introduced a second scan later in
pregnancy. Such men were 32 per cent more likely to be left-handed.
Reporting their findings in the journal
Epidemiology, the researchers said their results suggest a 30 per
cent increase in risk of left-handedness among boys pre-natally
exposed to ultrasound. "If this association reflects brain
injury, this means as many as one in 50 male foetuses pre-natally
exposed to ultrasound are affected."
Ultrasound scans use high-frequency sound to give
x-ray-like images of inside the womb.
A partner in Sydney Ultrasound for Women, Andrew
McLennan, said the suggested link to brain damage was "far from
proven".
"For 40 years there's been no evidence of
direct biological injury because of this test," he said.
"You have to take the context of the value of ultrasound and the
improvement in peri-natal outcomes into account."
More babies were able to be born safely because of
the identification of potential problems during pregnancy, said Dr
McLennan, who is also a foetal medicine specialist at Royal North
Shore Hospital.