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Re: OB: Suspected Macrosomia (long) From: Anna Meenan, MD (annam@uic.edu) Fri Feb 13 15:09:34 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: RModugno@aol.com: "Re: OB: Suspected Macrosomia (long)" Previous message: Elrod Glen Maj 3 MDG/SGOB: "Re: Clomid/IUI help desperately needed!" In reply to: Anna Meenan, MD: "Re: OB: Suspected Macrosomia (long)" Next in thread: art fougner, md: "Re: OB: Suspected Macrosomia (long)" Reply: art fougner, md: "Re: OB: Suspected Macrosomia (long)" Ooops, my apologies again, this time to Chris. It was Annemarie who accused us of putting $ before patients, not Chris. Chris actually does have a somewhat valid point about how the risks v. benefits of VBAC can be and frequently are slanted every which way when presented to patients. Someone from the list sent me a copy of his VBAC consent form a long time ago, and it was fairly well-balanced as far as the risks of either VBAC or scheduled repeat c-sec, but I can't remember who it was that sent it to me and I can't find it anymore either. We have been unable to offer VBAC at our hospital because anesthesia won't guarantee that all their guys will agree to come in and stay in-house during a VBAC. Also, our department obstetricians are divided on whether they will come in or not, so if someone REALLY wants a VBAC, we tell them to wait til labor starts, then if the right people are on call they can have a VBAC. And the hospital has been blasted in the editorial pages of the newspaper by a local midwife for not being able to guarantee a VBAC to every woman who wants one. We just can't win. -- Anna Meenan, MD At Fri, 13 Feb 2004, Anna Meenan, MD wrote: > >And to the lister who accused us of making all of our decisions based on >money (Chris, I think?): There are over 100 grade school and high school >teachers in my state who make more money than I do, to work far fewer >hours a year, and with far less education. Obviously, I am teaching the >wrong subject. > >-- > Anna L. Meenan, MD, FAAFP > Clinical Assistant Professor of Family and Community > Medicine, University of Illinois College of Medicine > >At Fri, 13 Feb 2004, Richard Chudacoff, MD wrote: > >>Why do people think that doctors are out to hurt them, when they seek care >>from the doctor in the first place? >> >>-- >>Richard Chudacoff, MD >> >>I believe we are on an irreversible trend toward more freedom and >>democracy - but that could change. >>Dan Quayle >> >>-----Original Message----- >>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of >>Len2976@aol.com >>Sent: Friday, February 13, 2004 2:03 PM >>To: Multiple recipients of list OB-GYN-L >>Subject: Re: OB: Suspected Macrosomia (long) >> >>Many years ago when I was in the AF stationed in California I saw a patient >>who was alternating visits between the AFB and a private MW. She planned a >>homebirth, but came for appointments to have a place to go in the event of >>complications. This patient also refused most labs, including glucola >>screening. >> >>As she approached her last weeks, it was clear the infant was large. >>Despite all counseling (shoulder dystocia, FTP, PPH), she was emphatic about >>the home birth. >> >>The day she delivered, I got a call from her MW. She had had a 10 1/2 # >>baby with the delivery complicated by a shoulder dystocia and she also had a >>4th degree perineal laceration. The patient came to the L&D unit with her >>husband, but she had been advised to come in without the baby, get repaired, >>and then sign out "AMA." According to the parents, the baby was "fine," >>but the laceration occurred during efforts to deliver the shoulders. >> >>I did do the repair (under pudendal anesthesia) since as a dependent she was >>entitled to care. Nothing anyone could say could convince either of them >>the risk they had taken and in their mind everything was fine. >> >>Lenora McCall, CNM >> Next message: RModugno@aol.com: "Re: OB: Suspected Macrosomia (long)" Previous message: Elrod Glen Maj 3 MDG/SGOB: "Re: Clomid/IUI help desperately needed!" In reply to: Anna Meenan, MD: "Re: OB: Suspected Macrosomia (long)" Next in thread: art fougner, md: "Re: OB: Suspected Macrosomia (long)" Reply: art fougner, md: "Re: OB: Suspected Macrosomia (long)"

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