Epidurals and bfing

Er, we don't *have* WIC. Parents on benefits would pay for their own
formula
out of that, just as they would after discharge.

so are there any additional benefits for families with young children?
formula after all is a significant extra cost, on top of regular benefits in
the UK, there is childbenefit, which is non means tested, but low income
families get milk tokens too, which allows reduced price formula, not sure
what the price is, but it's certainly not a free option, but once you stop
using formula, the tokens are for a pint of milk a day.

Cheers

Anne

On 2006-12-12 12:12:59 +0800, "cjra" said:


Notchalk wrote:

Ah, that's the different - you see them as patients. And you probably
see Midwives as nurses, too?


Once someone is admitted to hospital, yeah, I see them as a patient. I
will argue that many women don't need to be admitted to hospital to
have a baby, but once there, they are not in the familiar surroundings
of home and don't have everything on hand. It sounds like a woman has
to come with a pretty big suitcase to hospital just to give birth. I
guess it works, but sounds like a major hassle.

We'll have to disagree on that one. A normal birthing woman, to me, is
not a patient. She chooses to give birth in hospital for whatever
reason, doesn't make her a patient... she's not sick. But then
introduce any sort of medical care, and yup, I'd agree she was a
patient (ie epidural in labour, etc). Saying that, we do medicalise
the women in the postnatal ward with our BP checks and things, too. So
I can see where you are coming from.

The general stay is 3 days - The suitcase doesn't have to be that big.





(that sounded sarcastic, but it's not
meant to be). We as Midwives are there to care for and support women
antenatally, in labour, and post natally. Unless there is a medical
reason (postnatally) for them to be in hospital, I don't consider them
a patient.

Then why are they in hospital?

Most women think that is where you go to have a baby. And until there
is insurance for independent Midwives, and Medicare covered Midwifery
care, etc, it's going to stay that way.


What of
the woman who goes into pre-term labor? Of the planned homebirth that
has an emergency transfer?

Those instances are different - they are patients, then. However they
know they are pregnant (usually), so they know basically that they
might need to go to hospital eentually. I'd say they would have
gotten nappies for the baby, clothes, other supplies for the home, so
why not sanitary pads, too?

Sure. I had all that stuff at home. In the 10 mins or so when we
decided to call the ambulance and transport to hospital, we sure as
hell didn't have time to pack that stuff. And in the 36 hrs after DD's
birth, wondering if she was going to survive, the *last* thing DH would
have been able to do was go home and pack it all. Even when DH did get
a chance to go home, honestly he was rather distraught and basically
went to make sure the cat was inside, and fed and get his car. We don't
live near family. While we have friends around, no one had a key to our
house. In any case, what happens in those first hours, even if DH could
go home and pack everything, I bled thru quite a few sanitary pads in
the first 12 hours (beginning at 10pm). Now, I was at least prepared at
home, but I didn't get all my supplies til 36 weeks. What happens to
the woman who goes into labor at 30 weeks?

I've already said, for medical reasons, or when a woman simply can't
get hold of supplies, we have everything you could need.





What of the mother who *doesn't* have anyone
to call on to bring that stuff in?

As I said, we do have pads, etc. We have everything available that a
woman in hospital with a new baby would need ( apart from breastmilk).
However it's not up to the taxpaers to provide sanitary pads to someone
who is able to buy them, and knows she needs them.

Do care providers give a list to pg women during the antenatal visits
then?

yup
\


I'll assume you do have all the resources to help a woman nurse,
and I believe most can, but there do exist a few out there who can't
and they don't usually know til they try. I realize that number is
small, and I'm glad your hospitals really encourage BF, but what
happens to those people who don't have the resources?

Do you mean what if they can't afford formula and can't breastfeed?
There are programs, social workers, etc who can organise something for
them. While in hospital they can use the hospital's resources until
something else is organised for when they go home.

Well yes, that's what I mean. So there *are* hospital resources
available? That's where I'm concerned. I work with a low income
population (and in fact, tho a private hospital, the hospital where DD
was ultimately delivered serves a large indigent population, esp for
L&D and NICU).

Yup, there are - that's what I said in my original post.



What if the kid
goes to NICU, do they have to provide their own diapers there?

Then the child becomes a patient - NICU has their own funding for
everything a baby might need.


Who
keeps track of what each parent brings?

I am assuming you are refering to the NICU babies here? Each baby has
their own section in the nursery, and each parent might bring in
clothes, etc for the baby to wear. Each parent takes them home to wash
themselves. Nappies and formula if necessary is provided by the
nursery.

Interesting. The hospital where DD was would never have allowed that.
They wash everything once there. They are too accustomed to dealing
with an indigent population - people who don't have ready access to
laundry facilities, for example - that they don't really 'trust' what
parents bring into NICU. Maybe OTT, but I can fully see the need for
it.

Yeah, fair enough. Doesn't happen here. Those who wouldn't be trusted
to bring in clean stuff wouldn't be bothered to anyway, and that's why
there are hospital tshirts and bonnets if needed.



And frankly, with my kid in NICU, the last thing I wanted to do - or
had time for - was laundry, and I *do* have a machine in my house. The
most time I spent at home was to sleep about 5 hrs or pump. If I had to
go to the laundromat, no way could I have done that!

So you don't have to. Not every parent does this. Some do.


I guess it works for you, but it does seem like it could be a hardship
for the sorts of people I'm used to dealing with.

Different populations and different needs, I'm sure. I am in a capital
city, so places up north where there is an almost 100% indiginous
population might have different needs.


Jo

--
Woman, Wife, Mother, Midwife

And frankly, with my kid in NICU, the last thing I wanted to do - or
had time for - was laundry, and I *do* have a machine in my house. The
most time I spent at home was to sleep about 5 hrs or pump. If I had to
go to the laundromat, no way could I have done that!

So you don't have to. Not every parent does this. Some do.

I initially read this as you having to provide clothes for your kid, which
then would be a pressure, but it seems like it's a case of you have to do
the washing if you choose to provide the clothes, that makes a lot more
sense.

Cheers

Anne

Anne Rogers wrote:

I'm not sure where you draw the line, I mean the women knows she's going to
give birth, should the tax payer have to pay for that? why is the line at
the point of providing sanitary towels? I'm not saying women shouldn't, it
just seems quite arbitrary and I'd certainly rather get my own personally
chosen sanitary towel out of a bag, than have them on hand and getting germy
in the bathroom.

Hmm..If you go for a blood draw or immunizations, do you bring your own
alcohol pads and band-aids?

I think there's a lot wrong with the US healthcare system, but I do
feel that requiring patients (or pre-patients -- or utilizers of
healthcare providers) to bring their own supplies is a little odd, and
likely not to have any cost-savings impact whatsoever.

Given that the woman is presumably a tax-payer (or the spouse of a
tax-payer), it doesn't seem that far-fetched to have these supplies
provided, even within a single-payor system.

Caledonia

--
"Anne Rogers" wrote in message
...
And frankly, with my kid in NICU, the last thing I wanted to do - or
had time for - was laundry, and I *do* have a machine in my house. The
most time I spent at home was to sleep about 5 hrs or pump. If I had to
go to the laundromat, no way could I have done that!

So you don't have to. Not every parent does this. Some do.

I initially read this as you having to provide clothes for your kid, which
then would be a pressure, but it seems like it's a case of you have to do
the washing if you choose to provide the clothes, that makes a lot more
sense.

Cheers

Anne


I have had NICU babies in the UK and NZ. When DD1 was born in the UK I
didn't have clothes that fitted her (literally when she was born) so they
supplied clothing but we were told we could dress them in clothes we brought
along as long as we cleaned and dried them ourselves. We could also use
preemie clothes that were in the NICU and available to anyone to use, but
most new parents feel a need a label their child as their own by wearing
clothes from home if you know what I mean.

In NZ we were expected to supply all clothes needed. Initially this was of
no concern as 32 weekers only wear a nappy, but when they go into a normal
nursery you must supply the clothes. If you are unable to dress your child
then they will use hospital gowns and donated woollen clothing but this is
very discouraged.


--
Pip

My girls :
DD1 Jasmine - 5 weeks early - 21 March 02 -
Still as small as a peanut but as smart as a whip!

DD2 Abby - 8 weeks early - 3 Feb 05 -
I am very polite and say "Ank Ooooooo" whenever I'm given something.

"Yes you can drive me insane just by talking to me!"

In article ,
"Anne Rogers" wrote:

Er, we don't *have* WIC. Parents on benefits would pay for their own
formula
out of that, just as they would after discharge.

so are there any additional benefits for families with young children?
formula after all is a significant extra cost, on top of regular benefits in
the UK, there is childbenefit, which is non means tested, but low income
families get milk tokens too, which allows reduced price formula, not sure
what the price is, but it's certainly not a free option, but once you stop
using formula, the tokens are for a pint of milk a day.

We certainly don't have vouchers for anything yet, but it is being talked
about so that drug-addicted parents are unable to shoot up the entire child
benefit.

There is a large one-off payment to everyone who has a baby (over $3000 now, I
think), irrespective of income. I know, it's stupid, but it garners votes
(and babies). You get an immunisation bounty of $250 when your child is fully
immunised at 18mo. If the parents are out of work, an extra sum is paid on
top of unemployment benefits for each dependent child. We have never required
this so I don't know how much it is. There is another benefit to which most
people with children are entitled. And there is a child care rebate too.
Frankly, it's a dog's breakfast, and there is far too much money going to
people who don't really need it.

--
Chookie -- Sydney, Australia
(Replace "foulspambegone" with "optushome" to reply)

"Parenthood is like the modern stone washing process for denim jeans. You may
start out crisp, neat and tough, but you end up pale, limp and wrinkled."
Kerry Cue

Hmm..If you go for a blood draw or immunizations, do you bring your own
alcohol pads and band-aids?

well no, which was exactly what I was saying, why does knowing it's going to
be needed mean you have to provide it?

I think there's a lot wrong with the US healthcare system, but I do
feel that requiring patients (or pre-patients -- or utilizers of
healthcare providers) to bring their own supplies is a little odd, and
likely not to have any cost-savings impact whatsoever.

hmm, I'm guessing pads in bulk are pretty cheap, so you could say a pound
per patient, our local hospital had about 5000 deliveries, so that would be
5000 on pads, and a bit extra for storage and stocking and what not, doesn't
sound much compared to the overall hospital budget, it costs about the same
as 3 c-sections, but having seen things from the other side, it would also
only cost that amount to get all the breastfeeding training required for
meeting unicef baby friendly, so every single thing has an impact.

Given that the woman is presumably a tax-payer (or the spouse of a
tax-payer), it doesn't seem that far-fetched to have these supplies
provided, even within a single-payor system.

don't know about Austrailia, but the UK health system is chronically
underfunded, the amount spent per person is about half what it is in some
european countries that seem to have much more sucessful public funded
health services.

I don't think there is any right answer on this one, it's just one of those
things you need to know and there needs to be back up options when things
don't work out as planned.

Cheers

Anne

In NZ we were expected to supply all clothes needed. Initially this was
of
no concern as 32 weekers only wear a nappy, but when they go into a normal
nursery you must supply the clothes. If you are unable to dress your
child then they will use hospital gowns and donated woollen clothing but
this is very discouraged.

that would seem to put pressure on when you least need it, babies do seem to
get through clothes very fast and I know it doesn't take long to throw a
load of laundry one, but when your sleep starved and attached to a
breastpump, it would be a stress you could do without!

Cheers

Anne

We certainly don't have vouchers for anything yet, but it is being talked
about so that drug-addicted parents are unable to shoot up the entire
child
benefit.

I think the only thing that is directly vouchered is the milk in the UK.

There is a large one-off payment to everyone who has a baby (over $3000
now, I
think), irrespective of income. I know, it's stupid, but it garners votes
(and babies). You get an immunisation bounty of $250 when your child is
fully
immunised at 18mo. If the parents are out of work, an extra sum is paid
on
top of unemployment benefits for each dependent child. We have never
required
this so I don't know how much it is. There is another benefit to which
most
people with children are entitled. And there is a child care rebate too.
Frankly, it's a dog's breakfast, and there is far too much money going to
people who don't really need it.

I get confused over the exchange rates, there are no lump sums other than
maternity grants for very low income mums, but the weekly payments add up to
comparable amounts. I don't know how it works best, in the UK we get no tax
allowance for being married or having children, so a single guy pays the
same tax as the guy providing for a wife and kids, but the family then gets
child benefit and tax credit and so on, in the US we get tax allowances, so
instead of getting money back you just don't pay it to start off with, which
makes much more sense to me. There is always going to be loopholes in a
system which allow some to gain much from it for little input and for others
to fall through a loop hole and be in extreme poverty.

Cheers

Anne

Perhaps you should read the paper rather than relying on media reports.
It's freely available at www.internationalbreastfeedingjournal.com

cjra wrote:
wrote:

Pat O'Brien, a spokesman for the Royal College of Obstetricians and
Gynaecologists, said it was possible that fentanyl had an effect on the
baby.

Based only on what's quoted here, it's not clear that fentanyl had any
effect on the baby, only that there may be an association. And as we
all know, association does not equal causation. They'd have to do some
actual physiologic studies on infants (presumably they'd start by using
non-human primates)

Even simple studies like quantifying those babies which have trouble
latching/sucking might be an indicator. They allude to this, but I
don't see the specifics of that aspect of the study.

But he added: "There are other factors which may explain this link,
including that if a woman chooses not to have an epidural, she may also
be more motivated to persevere with breastfeeding.

I think this is a HUGE confounder. Not discounting the study, perhaps,
but is substantial enough that it makes the results weaker.

Anyone know the rate of epidural in the US?

Interesting initial study, but from a scientist's perspective, it's
very weak. At least as presented here. Of course, as prelim work it may
lead to more indepth studies. And just so you know my bias, I didn't
have an epi (planned a homebirth) and generally don't like the idea of
them.