other types of oxygen

[mommyshanti]

posted this in hombirth forum also but thought it might do better here since it is a question for midwives thanks

Any midwives that do not use/bring oxygen with them?
I asked my midwife she said she did not use it used something else that has been studied to be just as effective but I forgot what it was called?
reasons for this?
Of course I will bring it up later just wanted to hear some other imput.
She has had her own practice for over 10 years and is highly recommened so I have trust in her just trying to get a little more educated on it myself.
Thanks

[Midwife Kris]

Originally Posted by mommyshanti

posted this in hombirth forum also but thought it might do better here since it is a question for midwives thanks

Any midwives that do not use/bring oxygen with them?
I asked my midwife she said she did not use it used something else that has been studied to be just as effective but I forgot what it was called?
reasons for this?

I'm going to guess she said room air. In other words she might use the ambu bag to force room air, the same you are breathing right now, not 100% oxygen from a tank into the baby's lungs for resuscitation. Reasons? You'd have to ask her why she does this. The reasons can range from not being able to legally get a tank of oxygen to preference based on research from the UK where room air is used. Here in the US it is not the standard so I hope she will be ready with an explanation if a transfer for a compromised baby is necessary.

[nashvillemidwife]

I was thinking the same and posted so in the other thread. Doesn't the evidence say that PPV with room air is just as effective as oxygen? Of course, that doesn't mean much when you've got fetal distress or a baby that just needs some blow-by.

[mwherbs]

standards in NNR are to start resuscitation without oxygen because it can be harmful.

[mommyshanti]

if it was room air she did not use that term
she is licensed and also has neonatal rec card
hmm interesting

[mommyshanti]

Originally Posted by mommyshanti

if it was room air she did not use that term
she is licensed and also has neonatal rec card
hmm interesting

any of you midwives that do not carry oxygen?

[BrooklynDoula]

I've never seen a homebirth midwife here in NYC not have oxygen with them. It seems standard here.

[nashvillemidwife]

I don't know any homebirth midwives that don't carry oxygen. A lot of them carry more than one tank to each birth.

[mwherbs]

maybe she said positive pressure ventilation ? that is what using a bag and mask is called-
yep I carry oxygen because we are far from a hospital and at a certain point Oxygen is thought to be beneficial, it's just not something to start with

[mommyshanti]

Originally Posted by mwherbs

maybe she said positive pressure ventilation ? that is what using a bag and mask is called-
yep I carry oxygen because we are far from a hospital and at a certain point Oxygen is thought to be beneficial, it's just not something to start with

I am here in Va they have just been legally licensed here since 2005 and guess it was a long struggle. I read somewhere that they are not allowed to administer medications am guessing oxygen falls into that category am wondering about pit. and others. seems like that doesn't leave them much to work with in a situatiion that could be handled out of the hospital .
I guess they are working on switching this. I came here from Wa. adn I do not think they have this problem their

http://cfmidwifery.org/pdf/newslette...summer2005.pdf

[MsBlack]

I don't carry oxygen.

[JunipersMom]

I dont carry oxygen. I have a tank and just havent filled it. I'm also NNR certified.

[jenmidwife2b]

There are many midwives that don't carry oxygen. The midwife that I take my NNR cert from every couple years actually teaches about the harm that O2 can have on a newborn. I am apprenticing with a midwife who carries oxygen, and I am not sure if I will carry it with me or not.

[nashvillemidwife]

Do you believe oxygen can be beneficial in times other than resuscitation? Do you think you might ever wish you had some blow-by for a baby that was slow to pink up? Do you think it could help oxygenate a distressed fetus to give mom oxygen during pushing? What if mom hemorrhaged and was in shock?

[jenmidwife2b]

Well that's why I said I'm not sure. I used to work in the ER, and I have seen O2 be extremely benificial to shock victims and to those who have experienced severe blood loss. But the studies about the efficacy of room air are enough to make me question that although O2 is often beneficial, is it the best option? Again, I'm not totally sure, and I have time while I complete my apprenticeship to come to grips with this particular cunundrum.

[MsBlack]

Who knows whether a future birth will change my mind on this, but for now what I've seen is that at times when some mws might give mom some 02, I instead look toward optimum position for mom/baby and to coach mom's breathing. My favorite method for increasing oxygenation is to have mom take in as large a breath as she can, hold it for a count of 2 or 3 seconds, then release slowly. Usually we repeat this 2 or 3 times with good results. ANd always, while it produces an immediate benefit, it also seems to kick mom into a better relaxed breathing pattern generally. In some cases, I suggest this breathing be used after every contrax, unless/until things seem to improve generally for mom/baby (so far, never had to suggest it for more than a handful of ctx in a row, occasionally repeating later.

As for giving a baby blow by, well as I understand it there are some drawbacks to this anyway.

Mwherbs?

Was it you who once mentioned that in giving blowby, we might be working against what we want--that w/02 enriched air, baby doesn't need to breathe deeply to get sufficient 02...leading to shallower breathing and only extending the need for 02/delaying baby's transition to adequate lung function....? Whoever it was, it made sense to me as I have seen this very thing in action a few times (or so it looked like).

Again, the day may come when I believe it really is better to have 02 on hand, even if I rarely use it. So far, no.

[Nicole B]

...in giving blowby, we might be working against what we want--that w/02 enriched air, baby doesn't need to breathe deeply to get sufficient 02...leading to shallower breathing and only extending the need for 02/delaying baby's transition to adequate lung function....?

After my second birth I am a full believer in this!
I had a 37 weeker who came out pink and healthy and was breathing (I thought) very well. Nurses commented that she was having minor chest retractions and next thing I know she's whisked away without me even being told what they were doing with her and an hour later they finally got back with me telling me that she was under 100% oxygen! :
For over 5 days they worked on weining her off the O2 but her blood/O2 levels would crash every time. It was a slow slow process getting her back to room air again and I truely believe in my heart that that extended hospital stay was completely unnecessary and they just didn't give her enough time to adjust naturally herself.

If you've never actually breathed in your life and the first time you started breathing on your own someone immediately put you on O2 enriched air I can see how one would get rather dependent on that stuff

I hope the mw's out there that carry the O2 use it very sparingly and as a last option instead of a first response

[homemademomma]

Originally Posted by mwherbs

standards in NNR are to start resuscitation without oxygen because it can be harmful.

i believe the actual stated standard is that room air MAY be used but you are supposed to switch to O2 in something like 30sec if there is no improvement.

of course, the standard of care in most US hospitals is O2, so you will still come up with resistance if you transfer.

fwiw i think the research/info on using room air (at least to start) is very compelling. but i would still want my O2 there just in case!

[Jane]

I think it's important to have in case the baby has a congenital issue. If the baby is just not inflating it's lungs well or is slow to start, PPV is the answer. But a baby with a heart problem or lung problem that is severe is going to do better on oxygen + PPV.
I've also seen it be VERY reassuring to MILs and husbands - oh, you carry oxygen - midwifery isn't witchcraft, it's medicine!

[MsBlack]

Yes, carrying 02 can be very reassuring to some....altho I generally try to educate families about 02 use so that they reduce (or drop) their belief in it as a miracle cure--which it is not, nor is it without its own risks.

To me, midwifery is neither witchcraft NOR 'medicine' (at least, it's not medicine as understood within allopathy). It is midwifery....its own category.