Re: choices
From: art fougner, md (evsono@pipeline.com)
Fri Mar 19 11:52:17 2004
Charlie -
i thought the riskiest time was the time they sit inside a moving
automobile.
art
At Fri, 19 Mar 2004, Charlie Chambers wrote:
>
>Heidi
>
>You have some valid points, but one correction is necessary. The
>"well-meaning" obstetricians, midwive, etc didn't put in the patient's
>ear that with every intervention a perfect baby would result. Our
>society as a whole has grown to expect this outcome. People don't want
>to know that sometimes bad things happen to good people. Babys,
>unfortunately, will die. People will get cancer. Car accidents will
>kill people. I think one of our failures as a society has been in our
>inability to grieve and deal with loss. This evolution didn't happen
>because obstetricians told patients that if you have many ultrasounds,
>blood test, external monitoring, rupture of membranes, you will have a
>perfect pregnancy. I frequently tell patients that during their young
>lives, there riskiest time for health is while they are pregnant.
>
>On Mar 19, 2004, at 9:24 AM, Heidi wrote:
>
>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Elrod
>>
>>> My personal opinion is not that choices aren't a good thing, most
>>> certainly
>>> they are, its the issue of home birth that hits home, pardon the pun.
>>> We
>>> have a small hospital with 50 deliveries a month, with normal health
>>> population. In the last 6 months we have had an infant death in
>>> labor, a
>>> postpartum hemorrhage requiring an ICU stay for 2 days, 2 postpartum
>>> pulmonary emboli within hours to days of delivery and several of
>>> the "thank
>>> god I was close by" sort of decels. And this is a small facility!
>>> Yes,
>>> home deliveries are an option, so is driving without a seatbelt.
>>> Neither of
>>> which I would think are in the best interest of safety.
>>
>> How many of these complications were in women who had *not* received
>> induction/augmentation drugs or narcotic/epidrual analgesia? In
>> particular the pulmonary emboli were almost certainly complications
>> following surgery, correct? If we look at anecdotes alone (rather than
>> matched cohorts or prospective RCTs [which would be unethical, IMO])
>> then surely I can even make seatbelts seem dangerous ;) There are
>> plenty of 'case-studies' where a person is harmed due to having a
>> seatbelt ON at the time of impact, when perhaps if they had been
>> thrown free of the vehicle, they might have survived.
>>
>> We all agree that life is uncertain, and this includes childbirth.
>> What we're not quite seeing eye-to-eye on (and we may never, but I'm
>> very appreciative of the dialogue we've got going) is whether the
>> risks involved actually warrant ALL births occuring in hospital.
>>
>> I believe the safest outcomes (and this is supported by research)
>> result from the appropriate partnership between obstetricians and
>> midwives with appropriate training in recognizing and treating
>> complications and in knowing when to seek a second opinion. This is
>> something that is possible, but not without respect for the role we
>> each play in maternal/child health.
>>
>> Heidi Streufert
>>
>************************************************************************
>**
>
>--
>************************************************************************
>Charlie Chambers
>Hood River, OR USA
>cchamber@alumni. rice. edu
>
>"I'm a goin fishin.
>Yeah, I'm goin fishin
>And my baby's goin fishin too!"
> Taj Mahal
>
>************************************************************************
>
>************************************************************************
>
--
art fougner, md
ich bin ein New Yorker
