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17.03.2015

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So it appears that women and babies are being given high doses of antibiotics during labour without sufficient evidence to support the practice. View the situation positively – we are all getting time to prepare for the birth and the arrival of baby. This entry was posted in baby, birth, intervention, midwifery practice and tagged amniotic fluid, amniotic sac, augmentation, baby, birth, contractions, induction, nuchal cord, oxytocin, prelabour rupture of membrances, risk, syntocinon, waterbirth. I wish that I could go back in time and make my friend read this before she went to the hospital after her water broke. Upon arrival to the maternity ward I lied to the staff and told them my water had broken an hour beforehand.
I just love coming here and read all those things in a scientific manner that I know in my heart already. Unfortunately the hospital system and professionals don’t usually listen to intuitive knowledge. Uterine infection used to be, and still is in parts of the world, one of the major killers of women during the childbearing period. The last mother i know who had a uterine infection (not prolonged rupture but ventouse birth) showed symptoms at day 3 and was better within days of taking antibiotics.
It is very hard for doulas – all you can do is share information and support the woman. In conclusion I have to say I completely admire the way you work, and your attitude towards pregnancy, labour and birth, and, if I was to have another baby I would like you to come and look after me in England, if that would be OK!! I had to revisit this because of a comment made at a childbirth ed class tonight- a story was told of a mother who refused antibiotics after her water had been broken for more than 18 hours and her baby became septic. We did our own research into the lexical world of VAGINA, and this produced some interesting results.
Such terms are perhaps just about acceptable when you have a little girl with a tricycle injury and don’t want her uttering the C-bomb.
In light of this, it’s of utmost importance that you learn to call your VAGINA what it is, and furthermore, accept it in its natural state.
Rhiannon Lucy Cosslett and Holly Baxter are co-founders and editors of online magazine, The Vagenda.
Andy Slaughter, the MP for Hammersmith, who went to school with Alan Rickman, pays tribute. It is a tribute to his acting skill, his personality and unique voice and style that the sad death of Alan Rickman announced today went round the world on social media within seconds. Alan, Mel and Hugh all kept in touch with the school and continued to support it for decades after they left, in tribute to the liberal education it provided, with an emphasis on theatre and the arts.
I came across Alan not only at school reunions but at the Bush Theatre.  Always an exciting venue for new plays – and always existing on a shoestring at its long-term home above a pub on Shepherds Bush Green – the Bush got a new lease of life when a few years ago it moved to a better, more permanent home in the old Shepherds Bush Library in Uxbridge Road. I last saw Alan in the bar at the Bush last autumn, after the Visitors, a wonderful play by Barney Norris about the effect of Alzheimer’s disease, which moved him to tears.  After the production he was generous with his time talking to the public, the cast and Labour activists.


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The chance is small and you would need to induce labour in 50 women to avoid 1 case of infection. The diagnostic blood tests = Full blood count, urea creatinine, liver function test including urate and lactate dehydrogenase. I’m sure there is an elusive research study that found an increase in infection after 18 hours.
I just thought I would let you know how much I love this blog, it helps me come up with clear and concise ways of advising women of their options. From the Inga Muscio classic Cunt: A Declaration of Independence to Dr Catherine Blackledge’s The Story of V, to Caitlin Moran’s How to Be a Woman, women have been trying to wrestle their vaginas out of male hands and away from male terms which don’t belong to us for ages now. Women who choose to wait are often told their baby is at increased risk of infection and they are encouraged to have IV antibiotics during labour.
There are huge limitations when using surveys to assess experiences, and a good qualitative study is needed here.
Ashlee whose birth I recently attended has given me permission to share her experience and photos here. I think that women really need to read this before they go into labor and have decided what they will do if their water breaks and labor doesn’t start.
So besides antibiotics, steroids and 4 hrly checks (blood pressure, temperature, asking how the lochia was, any bleeding) it was just wait and see.
18 hours but do not support this recommendation with a research study that demonstrates an increased risk of infection after 18 hours. I am a midwife working in an MLU, and have to confess that I sometimes feel the women under our care are given less room for manoeuvre, as it were, than the women who book under consultant- led care. State representative Lisa Brown hilariously offended some Republicans last week when she had the temerity to utter the word during a ridiculously euphemistic debate about female contraception and abortion. Ashlee’s daughter Arden taught both her family and her midwives about patience and trust. They look at all studies on a topic and combine the results to avoid one-off findings influencing the overall findings. Being in hospital and having things put into your vagina after your membranes have ruptured = increased risk of ascending infection.
Fundamentalist Christians are no better, as the online post ’51 Christian Friendly Terms For VAGINA’, which jokingly suggests such legends as ‘sin bucket’, ‘devil sponge’ and ‘neighbour of anus’, goes to show.
Which is why it is of utmost importance that, if you can bring yourself to do it, you stop referring to your ‘la-la’ and start using the proper anatomical terminology. Research is not conducted in a vacuum, and the questions that are asked, and the methods used, tell us a lot about the social and cultural context of knowledge, and what is valued.


I used to see quite a few uterine infections as a community midwife in the UK doing postnatal home visits – mostly after forceps or ventouse births. And if the system is supposed to be evidence based (research evidence) then research speaks louder than the heart.
The same happened to Texas Governor Rick Perry, who since deleting the posts became the lucky recipient of oodles of hand-knitted and crocheted VAGINAS. We wouldn’t go so far as to suggest that you inundate the Facebook page of that ‘feminine hygiene product’ (read: vagina perfume) with ‘VULVA’ posts, but here’s the link and a labelled diagram of the general area. The implications of this unnecessary separation for the baby, mother and breastfeeding are ignored despite the available evidence supporting skin-to-skin contact. The effect I most often see is oral thrush in the baby and co-existing nipple thrush – and subsequent breastfeeding problems. After a 2 hour, 20 minute labour she was gently born through water and into her mothers arms (notice the nuchal cord). It just seems a bit of a risk and a waste to give antibiotics to all women in case they get something that is unlikely and very treatable if they do. Then there was the viral video, ‘Republicans, Get in my VAGINA.’ VAGINAS are back, and they mean business. Allowing uninterrupted skin-to-skin contact could reduce the chance of infection due to colonisation of the baby by mothers bacteria, reduced stress levels and early breastfeeding initiation.
However, more worrying are the potential long term problems associated with antibiotic exposure – most likely due to the disruption of gut microbiota and the integrity of the immune system.
Therefore there have been no studies looking at the effect of prophylactic antibiotics on mothers and babies or many other important questions.
The MLU invites women in who have had pre-labour ROM and we make sure the women are aware of the small risks you have mentioned, but we also have to book them in for IOL at their choice of hospital. If an independent midwife attends the birth she is outside her scope and guidelines and risks being reported. Research is expensive (I know I am doing some) and funding is often only available from industry sponsors. She chose to stay at home amongst her own familiar bacteria, and let her daughter decide when she was ready to be born.
I know when my babies were ready to be born and for many women, my mother and aunt included, the membranes release long before actual contractions begin. The irony is they were the ones who decided to use the antibiotics in the first place, and then became disillusioned with the whole cost implication.



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