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Posted on February 20, 2020

Sera + The Thomas Family

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I’m on the road and could be heading your way 🤗
Swipe for details!
I’m only able to offering limited services and bookings are essential. I’m also offering many services via zoom. I have limited access to internet so please send me an email enquiry through my website, as I won’t be able to check Instagram messages. I’m so excited to be able to provide my services with your communities in a new capacity!
We are still offering Postpartum massage, belly binding and postpartum closing ceremonies in Melbourne from November.

This ones for the follows… Adjusted odds ratios.

This ones for the follows…
Adjusted odds ratios.
What does that mean and why is it important when making an informed decision.
An odds ratio lets us know what the probability of something happening vs it not happening. It helps researchers come up with the 1:x chances of an effect occurring when an intervention is applied. Overall it can be pretty generalisable and doesn’t take individual variables (aka You) into account.
An adjusted odds ratio changes that number and is determined by differing variables. For example the chance of women having a particular outcome when given a particular intervention is x:X. However things like age, health status, your chosen care provider, ect ect ect, endless combinations of possibilities will change this ratio for you.
This is why research statistics are only one part of making a fully informed decision. You need to take your individual circumstances into account. Things that can affect the odds ratio are small sample sizes or bias in the population group who take part in the study. For example if you only choose women, or healthy participants or a younger age group, all these things can alter the odds ratio and sometimes curve results in favour of a certain statistical outcome.
Other things like your values, risk aversion and pervious experiences will also affect how you view the information presented to you from a study. It’s not uncommon for two people to look at the same study and come to different conclusions.
Seriously though, who else gets a bit hot learning about research.
📸 @oliviacalder

Evidence based care in maternity… Optimal cord c

Evidence based care in maternity…
Optimal cord clamping.
Also referred to as Delayed cord clamping, or really it should be Not cord clamping, because I feel those terms can be up to the cord clampers interpretation.
No other mammal or traditional midwife cuts the cord, with rich oxygenated blood and life force pulsing through it, immediately after the birth of the baby.
There really isn’t very much logic in doing so. This connection has grown & nourished the baby & provided it with oxygen whist in utero, what is the rush to severe it so quickly after birth.
Other than to seperate the baby from the mother to perform checks (also a non-evidence based, harmful practice).
Yet clamping and cutting the pulsing cord directly after birth is indoctrinated into fast paced obstetric practice & started without any research basis. Yet with all the evidence based reasons to support not doing so… It still is.
Why? Other then saving a few minutes, you’ve really got me “that’s the way we’ve always done things mentality”
An arbitrary time for delayed cord clamping like 3mins has been pulled. Stating beyond that there isn’t any supportive evidence and most of the blood had gone through.
These times coincide with the use of synthetic oxytocin given after birth which cause strong contractions & force the placenta off the wall of the uterus more quickly than it naturally would have.
I have supported births where at 20mins+ there is still pulsation in the cord.
If your baby is slow to take their first breath it is even more important they stay connected to their supply of oxygenated blood. Research on resuscitating babies with cords attached & the benefits has finally been done, yet the practice slow to implement in hospitals.
Benefits of waiting until white:
•Higher blood volume
•Better iron stores for the first year of life
•Stem cell rich blood in the place it is intended (Stem cell harvesting = $$$)
•Increased brain myelin which supports brain function
•For preterm babies less need for blood transfusion, lower incidence of NEC a high morbidity condition
Was your decision for delayed cord clamping respected?

Evidence based practice. This is an approach to he

Evidence based practice.
This is an approach to healthcare that implies that the most current and reliable research supported information is being used to guide practice. There are three important components:
-Best scientific evidence
-Patient values
-Clinical experience
Although it sounds logical to practice in a way that aligns with the most current scientific evidence, it’s actually not that straightforward.
Translating evidence to practice can take a long time (hello decades of research promoting the benefits of midwife led continuity of care).
Barriers can include associated costs, lack of training, culture (yours, the providers and the hospital or practice setting), medical hierarchy and rewriting guidelines. It’s estimated 40% of people receive treatment which does not aligned with evidence, is unnecessary and potentially harmful.
Your care providers clinical experience is important and it contributes to your safety. Just because the best available evidence suggests one treatment, if your care provider isn’t skilled in delivering it, it diminishes its safety. And no one benefits from a care provider bringing fear into your birth space if they are not confident in supporting what you want (try and find someone else!). But importantly your values and personal circumstances are so important. That’s why continuity of care in any setting has benefits. Because how that evidence can be applied to your personal circumstances matters. What is right for one person mightn’t be right for you!
📸 @vida_images

Grab yourself a cuppa, I’m about to drop you a s

Grab yourself a cuppa, I’m about to drop you a series. It’s all about informed consent and the reality of evidence based practice in the maternity system. However, this information can be applied to any situation.
First of all we need to start with everyone’s favourite buzz word right now… Research aka “the science”.
As a health care practitioner and one currently studying clinical trials in my masters degree, I feel my last 8years have been consumed with how to read and understand research. It’s not easy. It’s convoluted. You need to learn to critically appraise, read between the lines and through the motives of sponsors (aka the ones fronting the $$$).
Two people from different disciplines could read the same research and come to completely different conclusions and practice recommendations because of their knowledge, experiences, perception of risk and most importantly who they have to answer to (insurance, registration) and what they have to loose (their livelihood or reputation). Examples of this the Term breech trial and the Arrive study (look them up! Floored studies, both have been debunked but are still quoted and guide practice because they push the agenda of induction and cesareans).
Research is expensive, like really expensive. So the reason many “alternative” or lesser known therapies aren’t evidence based is because they can’t afford the big studies to prove their effectiveness.
There are a few things to unpack when reading a piece of research.
•The validity- how relevant is the design of the study to real world circumstances?
•Any biases- who is running the trial? Could they financially benefit from a certain outcome?
•Study design- Not all studies are made equal, their is a hierarchy (this is beyond an Insta post but there’s plenty of resources explaining this)
•Study population- What is the population being studied? Were they cherry picked by those running the study to produce certain results? Is the population group relevant to me? If I am a healthy individual with no co-morbidities when the study group includes people who are overweight, unwell and on medication… how relative are those statistics they’re quoting to me?
Continued in comments…

Following on from a comment about appreciating my

Following on from a comment about appreciating my authenticity. Firstly 🙏 Thank you.
I want to tell you a story about how I got to a place comfortable enough to show up how I do.
It wasn’t an easy lesson, but it was one of the most valuable.
In my early midwifery years I worked with an older midwife who was not easy on me in any sense. She called me out. She did her thing and didn’t care how it effected me. She unapologetically lived true to herself. She told me stories of her life and I could see she hadn’t always been here. She had worked and endured and coped a lot along the way. But she was in a place now where she did not give a fuck. She was knowledgeable, outspoken and well respected.
And I decided that it shouldn’t be necessary for women to get knocked down, walked over and pissed off for the majority of their lives to get to this point. Not to say I haven’t experienced this, I’m sure we all have. But it’s old news and I’m done with it. Plus I’ve seen and heard of too much unjust and cruel treatment of women and I won’t stand silent in that.
So here I am unapologetically, authentic, taking up space.
If you don’t like it, seeeee ya, I stopped caring years ago.
📸 @oliviacalder

images by VidaImages

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