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Re: CNM CasesFrom: Elrod Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)Mon Nov 29 01:26:10 2004
How do you make it known that you won't care for them? Is it posted, or asked at a prenatal visit and then the patient disengaged? Glen D. Glen Elrod, Maj USAF, MC Obstetrician/Gynecologist Maternal Child Flight 48 MDOS/SGOBO UNIT 5210 Box 23 APO, AE 09464 DSN (314) 226-8334 Comm 01638-52-8334 We have had good experiences with doulas, but I will no longer care for patients who use the Bradley "method" since, at least in our area, those choosing this method are antagonistic towards physicians and hospitals and work very hard to thwart all attempts to discuss reasonable courses of action to benefit the baby and/or mother. For example, the last Bradley method patient I had presented with 5 days of prolonged membrane rupture, a temperature of 104 F, fetal tachycardia above 210 bpm with absent variability, and thick meconium. She refused antibiotics, expedited delivery, intravenous fluids, etc, even after very respectful informed consent was provided. Interestinly, lots of Bradley patients in our area will have their baby in an "evil hospital" because insurance pays for it, rather than having the baby in a birthing center or at home, where, one assumes, the experience would be more in line with their demands. Ashley
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