Banner - Why Us

Blog - - Medicine

This is our blog.  It contains most posts Julian makes at his own blog, along with posts relating to the firm specifically: If Julian can convince them to do so, it will also include blogs by other staff!

Midwife versus Obstetrician: which is safer?

I note with interest media attention to the comprehensive study recently completed relevant to the safety of midwifery care (in part as an alternative to obstetric medical management) across all pregnancies.

This study confirmed that over an impressively scaled and vigorously qualified study group, the relative safety of midwife managed pregnancies, including labour and delivery was confirmed. This included high risk pregnancies, in which a view has previously been held that obstetric management would be significantly safer. Women were generally no safer with an obstetrician involved in their care.

Interestingly the study also found a significantly reduced proportion of deliveries in which instrumental assistance via forceps etc occurred, without harm to the outcome. Whilst this was not surprising, the fact that the safety of outcomes did not seem harmed by this reduction is.

Further, though in my view, less importantly, it was confirmed that the overall costs associated with pregnancy and labour were on average more than $500.00 less when a midwifery care model was used than otherwise. This is a significant cost difference when the number of woman giving birth each year in Australia is considered.

Stroke Treatment More Than 3 – 4.5 Hours from Perth (or another major city)

Interested talk at the recent annual ALA medical negligence conference in Sydney at which a stroke expert discussed a recently published large study of stroke treatment outcomes.

Such study clearly demonstrated the benefits, in terms of survival chances, of giving patients of any age thrombolytic treatment, if attending:

  • less than 3 hours after stroke onset; and
  • more importantly, even if not, provided still within 3 and 6 hours of their stroke.

The study results were apparently unexpected in that it had been commonly believed that such treatment was less likely to be effective in older patients.

The speaker confirmed that such treatment should be given by suitably trained and experienced medical practitioners…..

The question this raises, for patients suffering stroke in our enormous State, is what about patients who attend hospital at an A+E department (in our far north for example) within this timeframe, but with no reasonable means by which the can be transferred to a major facility within the time window?

Hopefully this is something WA Country Health Services and country hospitals themself have well in hand, both in terms of protocols as to the time for such therapy as well as training for practitioners so it can be administered.

An important issue given stroke is Australia’ 2nd largest cause of death and responsible for 1 in 7 deaths…