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Re: VBA3C From: Garry E. Siegel, M.D. (garrys@mindspring.com) Sat Feb 7 09:30:48 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Stmidwife@aol.com: "Re: Billing" Previous message: Joanne Bulley, MD: "FRI: Humor" In reply to: Ana : "Re: VBA3C" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: VBA3C" No, I would not give her a chance in my practice. It would be either against advice (and documented as such), or I would suggest that she go elsewhere. If I felt it necessary, I would dismiss her. If she stayed, but didn't cooperate--meaning that she wouldn't allow scheduling a section, or if in labor, refused a section--then I would simply document, document, document. Every once in a while, people might stay in the practice and "lead you on" to think they will do that which you ask, but when it comes time, they don't (i.e. I'll schedule a section, or I'll have a section when in labor, and then refuse). I would not induce, and probably not augment her. I think John has said it right--it's OK as long as you don't mind taking a chance that you and/or your baby could die, and if needed, I would say just that. Garry >> >>I found this website purporting the benefits of "Vaginal birth after 3 >>(or 4) csections." I now have a nurse patient interested in a trial of >>labor after 3 prior low transverse csections. Would anyone give her the >>chance? >> >>I tend to draw the line at 2 prior, but she is insistent. >> >>By the way...with the new log in system, do you need to come back to the >>website to reply or can you reply to all from your email? >> >>Thanks >> >>-- >>D. Glen Elrod, Maj, USAF, MC >>Medical Director >>Women's Health Clinic >>Elmendorf AFB, AK 99506 >> >As long as she understands that either she or her baby have a real >chance of dying in labor what's the problem. > >If she really is serious about continuing ask her how she feels about. > >1.) Continous fetal monitoring, if she says no tell her she shouldn,t >bother having the baby in a hospital because it won't make a difference. > >2.) Induction or augmentation, if she says no ,I would tell that's fine >with >me but what's the plan if she doesn't go into labor by 42 wks, or 40 >plus 10 days as is popular these days. > >3.) Hysterectomy for massive bleeding, if she says no well that speaks >for itself my time and her time could be better spent elsewhere. > >-- >Take care, John > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Stmidwife@aol.com: "Re: Billing" Previous message: Joanne Bulley, MD: "FRI: Humor" In reply to: Ana : "Re: VBA3C" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: VBA3C"

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