Really? I did kind of think that, but wasn't sure. Well I guess if a IM is supposed to have that stuff ready, then the doc should have a right to say no. It doesn't make any sence
Registered User
Really? I did kind of think that, but wasn't sure. Well I guess if a IM is supposed to have that stuff ready, then the doc should have a right to say no. It doesn't make any sence
BellyBelly Life Subscriber
The problem here is that syntocinon is a prescription only drug. As is vitamin K. In hospital it is given as part of a standing order, and hospital midwives have access to it as needed, but this is obviously not the case for independent midwives. Yes, most midwives carry it, but unless the woman can get a prescription for it, thry only have two options - either obtain it from a hospital (which is obviously theft, and against the law) or not use it and transfer in at the first sign of bleeding. Oxygen, on the other hand, does not require a prescription and is therefore much easier to obtain.
Registered User
I wonder how my midwife gets access to it then? She's not affiliated with the hospital and I didn't transfer when I had my bleed, but she sure stuck something in my leg to make it stop.. LOL.. and I can't see her wandering through the halls at the hospital preparing to steal it either.. bahahahaha
Registered User
The birth centre would be affiliated though I'm guessing. So Schmickers, in essence this isn't a new thing that has all of a sudden happened, women have always had to get a script filled, but considering the current issues surrounding HB, this is a typical media beat up to turn a non-issue into a scandal? I always thought that the midwives provided those things because that was my understanding based on different things I have read supporting HB - like if you have a bleed then your midwife will have the syncto etc.
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Hmm I dunno? You do have to register with the hospital in case of transfer, but they take anyone at all - so its not like a normal birth centre attached to a hospital where if you are too "risky" you don't get accepted?
Now I'm all confuzzled.. lol
Registered User
I know with the main hospital in Perth that if you are booked through their birth centre, you are also booked into the main hospital in case of transfer. That is one of the good things about affliated centres, unfortunately though they will also have policies and proceedures and guidelines as well.
BellyBelly Life Subscriber
hmm... I'm sure the midwife I spoke to said she carries synto, and that I would only need the GP for u/s referrals, blood tests and scripts for vit K & hep B if I wanted them.
I don't think the argument should be so much about GP's having the right to refuse the script (I agree with muminalice's post).. but more that midwives should be able to prescribe these themselves. They are the pregnancy/birth care providers, they should be able to prescribe the relevant drugs.
My dentist can prescribe antibiotics for an infected tooth without sending me to my GP.. a midwife should be able to prescribe synto, and refer for ultrasounds too for that matter, without a GP. JMO.
Registered User
Ok, thanks Schmick. Makes more sense now
Registered User
Now this is one of those situations where being able to access a homebirth through a hospital clinic or a hospital affliated birthing centre makes sense as the hospitals standing orders would apply to these medications. Though saying that, some hospitals are really cutting back on their standing orders and you now have to have prescriptions for just about everything.
Registered User
I just cannot believe how much the AMA misses the whole, entire, friggin point. There are lots of women who CHOOSE not to want a doctor to 'treat' their pregnancy. But what the AMA wants, under Pesce, is to force doctors upon women who want a HB whether they want a doctor or not, just so that they get their cut of the friggin economic pie. It's not about safety or women at all. It's about getting a look in. They KNOW how successful the HB programs are overseas and they don't want it catching on!
So, even if an IM comes with you to a GP appt, the doc can still veto and THAT'S considered 'collaborative'.
No, no, no, no, no, no, NO!! If I don't want a doctor involved unless medically necessary, then I don't want a doctor, that's kind of the whole point of going HB!
If synto is so much a part of birth (as it is in Oz), then you would think that out of true concern for safety of birthing women, IM's would have access to this without the need to go through a doctor first. It is absolutely clear which way the bias lies.
Registered User
To be fair to doctors, they don't have to prescribe you something just because you ask for it, and unfortunately there is probably no way to check if a letter from an IM is legitimate or not. Also some might not be familiar with the dosing of syntocin and vit K and while yes these can be looked up, the dosing and route of administration comes back to them and personally, I would feel uncomfortable prescribing a drug I was unfamiliar with just because someone I might not have met before came in with a letter from someone I do not know asking for it. If you need the prescription take the IM with you to explain the need. Just about all doctors I have worked with and dealt with personally can be reasonable if presented with a good rationale for why something is needed. I wouldn't be happy with a doctor who gave me antibiotics just cause I went in and asked for them I would expect to be examined and asked questions as to why I thought I needed them, and in a way this is no different.
Registered User
Well it seems to me it all goes hand in hand with banning home birth. Another way around women having access to a safe HB.
If syntonin isn't accessable by even IM's then some women would reassess their options wouldn't they. Another way of bullying women into doing what they aren't comfortable with, just because they are thinking about the safety of themselves & their babies.
I understand a doctor has the right to say no, but an IM should be able to access something that could save a life!
I'm not sure what I'm trying to say is coming out right
Registered User
My midwife had vit k and synto.
I can see both sides of this issue, but really, midwives should be able to access this stuff without a Gp. I know my gp wasn't keen on my homebirth idea but he would have prescribed the meds if I asked. I think some gps are ideologically opposed to homebirth, which is fine, but why are they even in the equation?
Butt out doctors...butt out pesce. My vagina, my choice!
Doctors can have the same attitude - my prescription pad, my (potential) legal risk. My choice.
I wouldn't blame any Dr for refusing to prescribe in this situation.
Simply find another Dr who is prepared to do it and get over it in my view.
BellyBelly Life Subscriber
They could always call the midwife...give this 'collaborative' stuff an actual try before deciding they can't collaborate with an IM.
The IM would know the dosage. Which they would cover in the letter. It might be easier for the doctor to see the IM, but I'm sure the IM has other things to do, not to mention the unnecessary cost to the mother for an extra consult? Perhaps Maya is right, and it really is a power thing - if my GP wrote a letter, my specialist wouldn't be saying 'hmm not sure I can verify the authenticity of this letter, can you bring him in to chat with me?'
Certainly easier access to the necessary drugs for IM's would make this whole thing a lot simpler and less discriminatory. As Trill says, planned freebirths are a whole different ball game, I'd be advocating a freebirther transfer with good advocacy/support in place if there were complications.
Registered User
I agree with muminalice, a letter from an IM or even meeting the IM is no proof that the script request is legit. A proper collaborative relationship where both parties trust one another is what is required IMHO.
Registered User
But if there were concerns with a doctors identity, they can always check their medicare provider number to verify, if there was such a system for midwives that made it easier to verify a letter from a professional IM if the doctor had any doubts. Yes they could check with the nurses board if they are registered as a midvife, but it wont tell them if they are a practicing independent one. I am not a midwife but a registered nurse and but I can access drug dosing information and use the right terminology to make a letter look legtimate, forge a midwife colleagues name and find out her regsitration number and provide that as well if I wanted. It is not hard.They could always call the midwife...give this 'collaborative' stuff an actual try before deciding they can't collaborate with an IM.
The IM would know the dosage. Which they would cover in the letter. It might be easier for the doctor to see the IM, but I'm sure the IM has other things to do, not to mention the unnecessary cost to the mother for an extra consult? Perhaps Maya is right, and it really is a power thing - if my GP wrote a letter, my specialist wouldn't be saying 'hmm not sure I can verify the authenticity of this letter, can you bring him in to chat with me?'
Certainly easier access to the necessary drugs for IM's would make this whole thing a lot simpler and less discriminatory. As Trill says, planned freebirths are a whole different ball game, I'd be advocating a freebirther transfer with good advocacy/support in place if there were complications.
I have seen some GP's referral letters and I would want to see them to for some of the stupid and unhelpful information they provide (as in please see patient, she is complaining she is unwell). As well a specialist should examine you and come to thier own conclusions and not just rely on a GP's letter.
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