Apropos the family Nikki wrote about who refrained from entering the
hospital until their breech baby was on the way out with one foot first -
this kind of unsafe behavior is what results when people are not respected.
Communication goes down the tubes first, and from there on nothing is much
fun.

In Norway, a frank breech is not an automatic indication for cesarean
section.  If a foot prolapses before complete dilation, emergency cesarean
is the policy.  So she might have had a CS here after all.  Impossible to
say.

Recently, I arrived at work and learned that the 3 midwives who staff the
labor ward at night had had 6 births since 2 a.m.  They had called in extra
help, one more midwife, because not one but TWO primips were in labor with
breeches.  Both gave birth normally.  That's when we looked at our census on
the postnatal ward and realized that the last woman delivered by CS in our
hospital had gone home two days earlier, on day 3 post partum, meaning there
had not been a cesarean in 5 days.  Considering we have about a 14 per cent
CS rate and we had had at least 35 births in that time period, including
vertex/breech twins and three other breeches, we were ecstatic.  There
should have been 5 cesareans for that number of births if we are to
*maintain* our average, and there were none.  Since January 1 our rate has
declined markedly, with no change in official policy, and we don't know
exactly why but we like it.  Make that LOVE it.  It's so much easier to work
post partum when you can concentrate on helping mothers with breastfeeding
rather than having to wait until after you've done all the surgical nursing
tasks first.

Despite this cesarean drought, I spent most of my shift working with mothers
experiencing significant difficulties with breastfeeding.  Most of them had
given birth normally and had uninterrupted skin contact with their babies
for the first couple of hours, and where this was not the case there was a
good reason.  I suspect it is the narcotic analgesia (Fentanyl) given to
women in labor that makes it hard for some babies, but some of the really
difficult ones have been completely unmedicated too.  Except for the baby
whose tongue tie didn't get dealt with until day 5, I am stumped.  Go figure
- and when you do figure it out, let me know, somebody, OK?

Rachel Myr
Kristiansand, Norway

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html