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Re: New Zealand System From: Anna Meenan, MD (annam@uic.edu) Sat Feb 14 23:33:02 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anna Meenan, MD: "Re: Introduction" Previous message: Stmidwife@aol.com: "Re: OB: Suspected Macrosomia" Our problem here is that we have so many folks who only want to take responsibility for their decisions if everything goes well, and want to look for someone else to take responsibility if things go wrong. How nice it must be for you if women in New Zealand actually do take responsibility for their choices. I know what you mean about learning from the ones that push you out of your comfort zone, though. Years ago, fresh out of residency, I attended a birth for an extremely needle-phobic mom. She allowed our needles as long as she was pregnant, because we could always get her cooperation where the baby's health was at stake (though our lab lady sometimes had to back her into a corner in the exam room to draw blood), but right after the baby was born, she had this decent-sized 2nd-degree lac. and refused repair. She said "The baby's out now---no more needles." The nurses wrote up a long refusal form for her to sign and I told her to keep her legs together, and believe it or not, it healed great. I have never left a lac. that large unsutured since then, but I sure have left some smaller ones unrepaired that I never would have before that. Now, however, having spent 20 years in practice and been fooled and deceived many times, I am much less trusting of people who SAY they want to take responsibility for their own decisions. -- Anna Meenan, MD At Sun, 15 Feb 2004, Kipperkid wrote: > >Hi Anna >Thanks for the support, I'd just like to clarify that I don't really think that Doctors put money before women, most of the time I think that Doctors are really trying to provide quality care, although we'll probably have to agree to differ on what actually constitutes quality care. For me one of the challenges (and joys) of providing midwifery care is the woman who pushes me out of my comfort zone, the woman who declines (I much prefer that term than refuses) the option that I'm most comfortable with, and pushes me out on to that shaky limb where I'm not quite so comfortable (goes without saying that my shaky limb is probably different from the majority on this list)...but it is those women that I learn so much from, it is those women that teach me everytime that they know themselves best...I've done my three year degree and can provide options for care but ultimately she must choose what is the best option for her...and yes that sometimes means that I practice with the Health and Disability Commissioner and the threat of disciplinary action on my shoulder, and it is then that I make sure that I document document document, every discussion, every decision. >I'm an independent practitioner, one bad case and my **** is on the line, if I don't have any clients then I don't have any money either, so my reputation is crucial to me, but it still doesn't prevent me from valuing informed decision making and partnership with women above the $ as my motivating force. >I agree strongly that your legal system needs to change to prevent the frivolous or ill informed action taken. I'm quite happy to talk about how our system works but don't want to clog the list with discussion that might not be welcome. > >Annemarie, RM, B.Mid (I don't usually use this but it seems that qualifications are important to this list!) Next message: Anna Meenan, MD: "Re: Introduction" Previous message: Stmidwife@aol.com: "Re: OB: Suspected Macrosomia"

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