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Re: OB: Home birthsFrom: Marie Harkins (mharkins@twcny.rr.com)Tue Nov 15 08:46:07 2005
Garry, Your practice is being put in an awful position. I think that it is entirely appropriate to discharge these women from your care. It could be stated in an introductory letter that you value an open and honest relationship with your patients. If this trust is violated by someone using your group for prenatal care but planning a homebirth, care from your practice will be terminated. This would bring up this issue at the 1st visit and focus on your requirement of an honest patient/provider relationship vs condemnation of home birth. It is also an issue that your CNMs could directly discuss with the woman at the first visit. If these women need to be transported from home, is your practice then responsible for providing the hospital care because they have been established with you during the pregnancy? It is probably not legal or ethical to have them enter the "county call" system since they have seen you for care. If it were possible, that would be another deterrent to them seeking your practice out.
-- Marie Harkins, CNM Ithaca, NY
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